Intraoperative Suction-Assisted Kyphoplasty for Immediate Removal of Posterior PMMA Extravasation in Decompressed Vertebral Compression Fractures

TL;DR

A new surgical technique using suction during kyphoplasty helps remove leaked cement in vertebral fractures, preventing spinal complications.

Contribution

A novel intraoperative suction-assisted method is introduced to manage posterior cement leakage during kyphoplasty.

Findings

The suction-assisted technique successfully removed posterior PMMA extravasation during the procedure.

The approach prevented spinal cord compromise and avoided the need for additional surgery.

The patient experienced rapid pain relief and early mobilization post-procedure.

Abstract

Background: Vertebral compression fractures are prevalent in elderly patients with osteoporosis. While the vertebral augmentation procedure is often used for symptom control and improving life quality, cement leakage is still a significant complication of vertebral augmentation procedures. This case report describes a 92-year-old man with a T8 compression fracture who underwent kyphoplasty with low-viscosity bone cement after failed conservative treatment. Methods: A previously developed decompressed kyphoplasty technique using dual portals was employed to reduce intravertebral pressure; however, fluoroscopy revealed posterior leakage toward the spinal canal. A case-specific intraoperative modification of this established technique was then applied, converting the injection portal into a suction channel to aspirate extravasated cement before it hardened. Results: This approach averted spinal cord compromise, obviated the need for additional decompression surgery, and preserved neurological function. The patient achieved rapid pain relief and early mobilization. Conclusions: This case demonstrates how a suction-assisted intraoperative maneuver may be used to manage posterior cement leakage during decompressed kyphoplasty.

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