Lesión medular como complicación de la vertebroplastia y la cifoplastia

Vertebroplasty and kyphoplasty are minimally invasive percutaneous procedures indicated in the treatment of back pain associated to osteoporotic and cancer-related spine fractures. Although that procedures have proven to be safe, complications can occur, especially those derived from bone cement leakage. Two female patients, 37 and 62 years old, booth with multiple thoracolumbar spinal fractures, traumatic and osteoporotic etiology, with posterior wall involvement. After the performance of the techniques both developed spinal cord injuries due to bone cement leakage into the spinal canal; the second case suffered also pulmonary embolism. To solve it, laminectomy was performed in both cases, along with the extraction of the material. The patients were admitted for rehabilitation treatment. Anticoagulation was indicated in the patient with pulmonary embolism. At discharge, both women presented functional improvement and were able to walk with the help of foot orthosis. We conclude that vertebroplasty and kyphoplasty are relatively safe procedures, although not without risks, as cement leakage into the venous plexuses has been reported. Correct selection of patients is important, checking the integrity of posterior wall. Also, patients must be carefully evaluated from a respirator y point of view.