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Delayed Paraplegia after Successful Percutaneous Vertebroplasty in a Patient with Osteoporotic Compression Fracture: A Case Report

Other Title
골다공증성 척추골절의 추체성형술 후 지연 발생한 하지마비 (증례보고)
Kim, YC; Son, WS; Suh, BK; Chung, NS; Kim, SW
Journal of Korean Society of Spine Surgery, 18(3):169-173, 2011
Journal Title
Journal of Korean Society of Spine Surgery
연구계획: 증례 보고

목적: 단순 골다공증성 척추 골절에 대해 추체성형술 시행 후, 후주의 손상을 동반한 탈구로 인해 불완전 하지마비를 보인 증례 1 예를 경험하였기에 보고하고자 한다.

선행문헌의 요약: 추체성형술은 골다공증성 척추 골절에 대해 안전하고 유효한 술식이나, 신경 손상을 일으키는 합병증들이 보고되고 있다.

대상 및 방법: 내원 12일전 골다공증성 단순 압박골절에 대해 추체성형술을 시행받은 81세 여자 환자가 내원 전 특별한 외상 없이 나타난 양측 하지 운동 및 감각 마비를 주소로 내원하였다. 영상 검사상 골절 추체 후주에서 후종인대 부분 파열, 극돌기 골절, 후관절낭 손상 등을 동반한 후방 탈구 소견이 관찰되었다.

결과: 응급으로 척추경 나사를 이용한 관혈적 정복 및 척추기기 고정술을 시행하여 신경 조직의 감압을 시행하였으나, 신경학적 증상의 회복은 만족스럽지 못하였다.

결론: 정확한 기전은 알 수 없으나, 추체성형술 후 후주의 손상이 악화되었을 가능성을 배제할 수 없다.

Study Design: A case report.

Objectives: We report a case of a female patient initially diagnosed as osteoporotic vertebral fracture without any noticeable injuries to posterior ligament complex, who later developed with incomplete paraplegia resulting from an unrecognized trauma after vertebroplasty.

Summary of the Literature Review: Vertebroplasty remains a safe and effective procedure for osteoporotic vertebral fracture. However, there have been many reports regarding neural injury associated with cement leakage.

Materials and Methods: An 81-year old woman with a sudden motor weakness and a sensory loss on her lower extremities after an unrecognized trauma was admitted to our clinic. She had undergone a vertebroplasty twelve days before the admission. At the time of vertebroplasty, Magnetic resonance (MR) imaging showed a compression fracture at T10 vertebra without any posterior ligament complex (PLC) injury. Follow up MR imaging was taken 12 days after vertebroplasty, and it revealed posterior shift of T10 body with a fracture of spinous process, tear of left facet joint capsule, partial tear of interspinous ligament of T10-11 with retrolisthesis, and narrowing of spinal canal at T10-11 by T11 lamina.

Results: Immediate surgical treatment was performed to decompress the neural structures, and to stabilize the spinal column. However, neurological recovery was unsatisfactory.

Conclusions: Spinal surgeons should be aware of the possibility of the development of any neurologic deterioration, even if successful vertebroplasty is performed.
하지마비추체성형술골다공증압박골절ParaplegiaVertebroplastyOsteoporosisCompression fracture
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Journal Papers > School of Medicine / Graduate School of Medicine > Orthopedic Surgery
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정, 남수
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