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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(02): 565-567
DOI: 10.4103/ajns.AJNS_253_18
Case Report

Navigation for tubular decompression of the l5 nerve root ganglion after cement leakage via a wiltse approach

Sebastian Hartmann
Department of Neurosurgery, Medical University of Innsbruck, Innsbruck
,
Pujan Kavakebi
Department of Neurosurgery, Medical University of Innsbruck, Innsbruck
,
Anja Tschugg
Department of Neurosurgery, Medical University of Innsbruck, Innsbruck
,
Sara Lener
Department of Neurosurgery, Medical University of Innsbruck, Innsbruck
,
Anna Stocsits
Department of Neurosurgery, Medical University of Innsbruck, Innsbruck
,
Claudius Thomé
Department of Neurosurgery, Medical University of Innsbruck, Innsbruck
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Osteoporotic vertebral fractures are a widespread problem in the elderly population. In experienced hands, treatment procedures are safe and can be done in a minimally invasive fashion. Nevertheless, in rare cases, severe complications may occur. We present a case report of cement leakage after vertebroplasty of L5 compressing the nerve root with neurological signs and radiculopathy. An 86-year-old female patient was introduced to our department with severe L5 nerve root radiculopathy and a foot flexion paresis after vertebroplasty of L5. Computed tomography (CT) of the lumbar spine revealed extraforaminal extravasation of cement around the nerve root causing significant compression. The patient underwent surgical revision using spinal navigation for skin incision, retractor placing, and verification of the cement extravasation. The cement plombage was removed, and the patient improved immediately. Sufficient decompression of the nerve root after cement leakage can be achieved using a spinal navigation setup in combination with intraoperative CT.

Key-words:

Cement leakage - navigation - neurological deterioration - radiculopathy - revision - vertebroplasty

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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