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Retrograde Flow Cement Leakage During Kyphoplasty – Balloon Kyphoplasty

Balloon Kyphoplasty

This article describes a rare case of retrograde flow of cement leakage during a balloon kyphoplasty procedure. The patient, a 55-year-old male with Langerhans histiocytosis, underwent the procedure under general anesthesia with raised intrathoracic pressure as a precautionary measure. However, during the last vertebral body procedure, the cement leakage was observed to flow downward in a retrograde fashion into the segmental vertebral vein, instead of following the expected upward blood flow. The procedure was immediately stopped, and there were no immediate adverse effects. However, six weeks later, evidence of pulmonary cement embolism was detected. This case highlights the possibility of retrograde cement intravascular flow due to increased intrathoracic pressure

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced treatment hospital in the world

Published article

Objective: To report a rare event of a retrograde flow of cement leakage during balloon kyphoplasty and discuss the possible mechanism. Methods:We present a 55-year-old male patient, who underwent a 4-level balloon kyphoplasty for Langerhans histiocytosis that had spread to the spine. With the patient prone under general anesthesia, intrathoracic pressure was raised as a precaution measure to prevent cement embolic complications as a protocol reported elsewhere. Results:During the last vertebral…

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Abstract Objective: To report a rare event of a retrograde flow of cement leakage during balloon kyphoplasty and discuss the possible mechanism. Methods:We present a 55-year-old male patient, who underwent a 4-level balloon kyphoplasty for Langerhans histiocytosis that had spread to the spine. With the patient prone under general anesthesia, intrathoracic pressure was raised as,

Abstract

Objective: To report a rare event of a retrograde flow of cement leakage during balloon kyphoplasty and discuss the possible mechanism. Methods:We present a 55-year-old male patient, who underwent a 4-level balloon kyphoplasty for Langerhans histiocytosis that had spread to the spine. With the patient prone under general anesthesia, intrathoracic pressure was raised as a precaution measure to prevent cement embolic complications as a protocol reported elsewhere. Results:During the last vertebral body procedure (L1), cement leakage was noticed to flow downward in a retrograde fashion into the segmental vertebral vein and the procedure was immediately discontinued. Cement leak did not follow the predictable upward blood flow through the anterior or lateral segmental vein into the vena cava, but instead, the cement followed a retrograde downward path into the Batson’s vein. No adverse cardiopulmonary effect was observed. Evidence of pulmonary cement embolism was detected in a routine thoracic computed tomography six week later. To our knowledge this is the first case in the English-speaking literature to highlight a retrograde cement intravascular flow most likely as a result of increased intrathoracic pressure.

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Retrograde Flow Cement Leakage during Kyphoplasty

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Abstract Objective: To report a rare event of a retrograde flow of cement leakage during balloon kyphoplasty and discuss the possible mechanism. Methods:We present a 55-year-old male patient, who underwent a 4-level balloon kyphoplasty for Langerhans histiocytosis that had spread to the spine. With the patient prone under general anesthesia, intrathoracic pressure was raised as

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