Extraction of cement leakages and malpositioned spindles complicating percutaneous interventions: why, when and how?
Cementoplasty
Foreign bodies
Intraoperative complications
Vertebroplasty
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
31
10
2021
accepted:
30
03
2022
revised:
08
03
2022
pubmed:
23
4
2022
medline:
19
11
2022
entrez:
22
4
2022
Statut:
ppublish
Résumé
Cement leakages in soft tissues are a common occurrence during cementoplasty. They may cause chronic pain, and thus treatment failure. Spindle malposition during reinforced cementoplasty may cause vascular, nerve or cartilage injury. Our goal was to evaluate the rate of cement leakage/spindle extraction and describe the techniques used. This retrospective monocentre study included 104 patients who underwent reinforced cementoplasty and 3425 patients who underwent cementoplasty between 2012 and 2020. Operative reports and fluoroscopic images were reviewed to identify extraction attempts and their outcomes. Six patients (5.8%) had a malpositioned spindle, and all of them underwent spindle extraction during reinforced cementoplasty, with an 80% success rate. A total of 7 attempts were performed, using 2 different techniques. One thousand one hundred thirty patients (32%) had a cement leak in soft tissues, and 7 (0.6%) underwent cement leakage extraction during cementoplasty, with a 100% success rate. A total of 10 attempts were performed, using 3 different techniques. No major complication related to the extraction procedures occurred. Spindle malpositions and soft tissue cement leakages are not uncommon. We described 5 different percutaneous techniques that were safe and effective to extract spindles and paravertebral cement fragments. • Soft tissue cement leakages or spindle malpositions are a non-rare occurrence during cementoplasty, and may cause technical failure and/or chronic pain. • Most soft tissue cement fragments and malpositioned spindles can easily be extracted using simple percutaneous techniques.
Identifiants
pubmed: 35449235
doi: 10.1007/s00330-022-08787-3
pii: 10.1007/s00330-022-08787-3
doi:
Substances chimiques
Bone Cements
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
7632-7639Informations de copyright
© 2022. The Author(s), under exclusive licence to European Society of Radiology.
Références
Weill A, Chiras J, Simon JM et al (1996) Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology 199:241–247. https://doi.org/10.1148/radiology.199.1.8633152
doi: 10.1148/radiology.199.1.8633152
Hulme PA, Krebs J, Ferguson SJ, Berlemann U (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31:1983–2001. https://doi.org/10.1097/01.brs.0000229254.89952.6b
doi: 10.1097/01.brs.0000229254.89952.6b
Barragán-Campos HM, Vallée J-N, Lo D et al (2006) Percutaneous vertebroplasty for spinal metastases: complications. Radiology 238:354–362. https://doi.org/10.1148/radiol.2381040841
doi: 10.1148/radiol.2381040841
Zhan Y, Jiang J, Liao H et al (2017) Risk Factors for cement leakage after vertebroplasty or kyphoplasty: a meta-analysis of published evidence. World Neurosurg 101:633–642. https://doi.org/10.1016/j.wneu.2017.01.124
doi: 10.1016/j.wneu.2017.01.124
Zhu S-Y, Zhong Z-M, Wu Q, Chen J-T (2016) Risk factors for bone cement leakage in percutaneous vertebroplasty: a retrospective study of four hundred and eighty five patients. Int Orthop (SICOT) 40:1205–1210. https://doi.org/10.1007/s00264-015-3102-2
doi: 10.1007/s00264-015-3102-2
Premat K, Clarençon F, Bonaccorsi R et al (2017) Reinforced cementoplasty using dedicated spindles in the management of unstable malignant lesions of the cervicotrochanteric region. Eur Radiol 27:3973–3982. https://doi.org/10.1007/s00330-017-4774-3
doi: 10.1007/s00330-017-4774-3
Kaufmann TJ, Wald JT, Kallmes DF (2004) A technique to circumvent subcutaneous cement tracts during percutaneous vertebroplasty. AJNR Am J Neuroradiol 25:1595–1596
Amoretti N, Hauger O, Marcy P-Y et al (2010) Foreign body extraction from soft tissue by using CT and fluoroscopic guidance: a new technique. Eur Radiol 20:190–192. https://doi.org/10.1007/s00330-009-1499-y
doi: 10.1007/s00330-009-1499-y
Shaikh H, Thawani J, Pukenas B (2014) Needle-in-needle technique for percutaneous retrieval of a fractured biopsy needle during CT-guided biopsy of the thoracic spine. Int Neuroradiol 20:646–649. https://doi.org/10.15274/INR-2014-10061
doi: 10.15274/INR-2014-10061
Durrleman J, Clarençon F, Cormier E et al (2013) Percutaneous removal of a soft tissue cement leakage complicating a percutaneous vertebroplasty by the mean of a supple biopsy forceps. J Neuroradiol 40:140–142. https://doi.org/10.1016/j.neurad.2012.01.131
doi: 10.1016/j.neurad.2012.01.131
von Elm E, Altman DG, Egger M et al (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:1453–1457. https://doi.org/10.1016/S0140-6736(07)61602-X
doi: 10.1016/S0140-6736(07)61602-X