Study Of Curative Effectiveness Of Percutaneous Endoscopic Technique In Intraspinal Cement Leakage After Percutaneous Vertebroplasty

Objective: To evaluate the clinical feasibility and safety of percutaneous endoscopic technique in patients with intraspinal cement leakage after percutaneous vertebroplasty(PVP).Methods: From May 2014 to March 2016,5 patients suffering from lower limb pain and spinal cord injury symptoms caused by intraspinal cement leakage after PVP,were treated with percutaneous endoscopic spinal decompression.Of 5 cases,3 were male and 2 were female,aged from 65 to 83 years(mean,74.4 years),the course of disease was 10-30 days(mean,16.2 days).Imageological examinations confirmed the levels of cement leakage,of which 3 cases were at T12/L1 level,2 cases were at L1/2 level.1 case was bilateral,4 cases were unilateral.2 cases had lower limb pain,whose visual analogue scale(VAS)scores were 8 points and 7points,3 cases had lower extremities weakness,whose Japanese Orthopedic Association 29 Scores(JOA29)were 18 points,20 points and 19 points.The grades of American Spinal Injury Association impairment scale were grade E(2 cases)and grade D(3 cases).The duration times of operation and intraoperative blood loss were recorded.Results: The operation time was 55-119minutes(mean,85.6minutes),and the blood loss was 30-80 m L(mean,48 m L).CT scan and 3D reconstruction at 1 day postoperatively showed all the cement leakage were all removed.All cases were followed up 6-21 months(mean,12 months).The symptoms of 2 cases suffering from lower limb pain were alleviated remarkably,and VAS scores at the last follow-up improved to 2 points postoperatively.The 3 cases suffering from lower extremities weakness had muscle strength improvements progressively,and the JOA29 scores at the last follow-up were 21 points,23 points and 22 points.Conclusion: Percutaneous endoscopic technique for intraspinal cement leakage after PVP is safety,effective and technically feasible.