gms | German Medical Science

Vertebroplasty is a procedure increasingly used for treatment and stabilization of osteoporotic vertebral fractures that have not responded to conservative management. In general vertebroplasty can be regarded as largely safe. In view of the increasing popularity of the procedure an increasing number of reports about complications have emerged. From a clinical point of view the frequently harmless complications (minor complications) like leakage of cement without symptoms, persisting pain and transient hypotensions can be seperated from the fortunately rare serious complications (major complications).

We report on 45 patients who were treated for one or several symptomatic osteoporotic fractures by percutaneous vertebroplasty in our university clinic from 3/2004 to 12/2004. Overall 57 vertebrae in the lumbar and thoracic spine were managed.

Initially a marked learning curve was observed. We report on two major complications, one an intrusion of cement into the spinal canal which required subsequent surgical decompression due to neurological deficit of the patient and secondly a case of severe postoperative haemorrhage bleeding requiring transfusion. 2 patients suffered rib fractures. Furthermore we deliver data concerning the minor complications observed in our patients.

"Pit falls" and strategies for reduction of complications are discussed. Conclusively there seems to be a significantly greater hazard of encountering complications in the thoracic than in the lumbar spine, most likely due to anatomical circumstances.