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Failed percutaneous kyphoplasty in therapy of stage three Kummell illness: A case report and literature evaluation.
Drugs (Baltimore). 2017 Nov;96(47):e8895
Authors: Zhang C, Wang G, Liu X, Li Y, Solar J
Summary
RATIONALE: Albeit it’s uncommon, the authors report a stage three Kummell illness case. It’s recognized by dynamic thoracic magnetic resonance imaging (MRI). As a result of there is no such thing as a established technique on stage three Kummell illness, we carried out percutaneous kyphoplasty at first, however sadly made a revision surgical procedure to take away the polymethylmethacrylate (PMMA) cement after the failure of percutaneous kyphoplasty.
PATIENT CONCERNS: A 73-year-old woman with extreme again ache attributable to osteoporosis vertebral fracture was admitted to our hospital on June 23, 2016. She underwent percutaneous kyphoplasty with the again ache improved shortly. Sadly, she went again to our hospital attributable to aggravated again ache and partial paralysis on July 25, 2016.
DIAGNOSES: Kummell illness, lumbar stenosis, lacunar infarction.
OUTCOMES: Specifically, the compression of spinal twine was apparent within the hyperflexion place on dynamic MRI. Though there was no enchancment in muscle energy, the affected person was glad with the again ache aid after percutaneous kyphoplasty. However, the identical again ache reappeared after about 1 month. Then, we took out the PMMA cement and carried out posterior vertebral column resection. Ultimately, the again ache was relieved once more however the muscle energy was improved not clearly after operation. On the similar time, the kyphosis was corrected and the intravertebral stability was achieved.
LESSONS: Dynamic MRI is useful in Kummell illness with neurologic signs, even when there is no such thing as a apparent compression within the impartial place. Moreover, the intravertebral instability might be the principle cause of the neurologic signs on this case. Percutaneous kyphoplasty couldn’t reconstruct the intravertebral stability. Stage three Kummell illness with apparent intravertebral instability ought to be handled by open surgical procedure.
PMID: 29382020 [PubMed – in process]