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

Sebastian Hartmann; Pujan Kavakebi; Anja Tschugg; Sara Lener; Anna Stocsits; Claudius Thomé

doi:10.4103/ajns.AJNS_253_18

Asian Journal of Neurosurgery, Table of Contents

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

Authors

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

Abstract

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

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References

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