Therapy of thermal injury due to bone cement leakage by cooled normal saline irrigation through epidural catheterization - A case report -

Introduction. Acrylic cement pulmonary embolism is a potentially serious complication following vertebroplasty.Case Report. A 70-year-old male patient was treated with percutaneous vertebroplasty for osteoporotic nontraumatic vertebral collapse of L5-S1. Asymptomatic pulmonary cement embolism was detected on routine postoperative chest radiogram and the patient was treated with enoxaparin, amoxicillin, and dexamethasone. At the followup CT scan no further migration of any cement material was reported; and the course was uneventful.Discussion. The frequency of local leakage of bone cement is relatively high (about 80–90%), moreover, the rate of cement leakage into the perivertebral veins (seen in up to 24% of vertebral bodies treated) with consequent pulmonary cement embolism varies from 4.6 to 6.8% (up to 26% in radiologic studies); the risk of embolism is increased with the liquid consistency of the cement and with the treatment of some malignant lesions. Patients may remain asymptomatic and develop no known long-term sequelae.Conclusions. Our ancedotal case illustrates the need for close monitoring of patients undergoing percutaneous vertebroplasty and emphasizes the importance of prompt and correct diagnosis and treatment, even if actually there is no agreement regarding the therapeutic strategy.

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Herniated disc of lumbar spine caused by bone cement leakage after kyphoplasty – A case report and literature review

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.106478 ◽

2021 ◽

Vol 88 ◽

pp. 106478

Author(s):

Shih-Wei Tzeng ◽

Ching-Lin Chen

Keyword(s):

Case Report ◽

Lumbar Spine ◽

Literature Review ◽

Bone Cement ◽

Cement Leakage ◽

Herniated Disc

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Percutaneous vertebroplasty versus kyphoplasty for the treatment of neurologically intact osteoporotic Kümmell’s disease

BMC Surgery ◽

10.1186/s12893-021-01057-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shou-qian Dai ◽

Rong-qing Qin ◽

Xiu Shi ◽

Hui-lin Yang

Keyword(s):

Blood Loss ◽

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Significant Difference ◽

Neurologically Intact ◽

Operation Cost

Abstract Background Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD. Methods The relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference. Conclusion PVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, while PVP has the advantages of shorter operation time, less radiation volume and operation cost.

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The influence of different inject hole designs of augmented pedicle screws on bone cement leakage and distribution patterns in osteoporotic patients

World Neurosurgery ◽

10.1016/j.wneu.2021.09.086 ◽

2021 ◽

Author(s):

Kaiyun Yang ◽

Yunhao You ◽

Wenliang Wu

Keyword(s):

Bone Cement ◽

Pedicle Screws ◽

Distribution Patterns ◽

Cement Leakage

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Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032010000200013 ◽

2010 ◽

Vol 47 (2) ◽

pp. 184-187 ◽

Cited By ~ 7

Author(s):

Luciano Lenz ◽

Veruska Di Sena ◽

Frank S. Nakao ◽

Gustavo Paulo de Andrade ◽

Maria Rachel da Silveira Rohr ◽

...

Keyword(s):

Median Time ◽

Normal Saline ◽

Thermal Injury ◽

Porcine Model ◽

Saline Solution ◽

Hydroxypropyl Methylcellulose ◽

Three Solutions ◽

Submucosal Injection ◽

Significant Difference ◽

Comparative Results

CONTEXT: Endoscopic mucosal resection is an established modality for excision of sessile lesions in the gastrointestinal tract. Submucosal fluid injection creates a cushion and may prevent thermal injury and perforation. OBJECTIVES: This blind study investigated the performance of three different solutions to create submucosal fluid cushions in porcine stomach. METHODS: Three solutions were injected in the stomach of nine pigs BR1: normal saline solution, carboxymethylcellulose 0.5% and hydroxypropyl methylcellulose 0.25%. In each pig, submucosal injections with 6 mL per test-solution were performed. One drop of methylene blue was added to all injections for better visualization. The time for the bleb to disappear was recorded. RESULTS: The overall median time of visible submucosal cushion was 37 minutes (range 12-60 min) for hydroxypropyl methylcellulose, 31 minutes for carboxymethylcellulose (range 10-43 min) and 19 minutes for normal saline solution (range 8-37 min). There was no statistically significant difference neither between normal saline solution and carboxymethylcellulose (P = 0.146) nor carboxymethylcellulose and hydroxypropyl methylcellulose (P = 0.119) but the median duration of hydroxypropyl methylcellulose was significantly longer than normal saline solution (P = 0.039). CONCLUSIONS: The length of hydroxypropyl methylcellulose submucosal fluid cushion is longer in comparison with normal saline solution. The median time for carboxymethylcellulose was not longer than normal saline solution. Hydroxypropyl methylcellulose, in the concentration of 0.25%, may be a durable alternative for submucosal injection.

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Severe haemodynamic disturbances following normal saline irrigation in cerebro-pontine tumour surgery

Indian Journal of Anaesthesia ◽

10.4103/0019-5049.98798 ◽

2012 ◽

Vol 56 (3) ◽

pp. 312

Author(s):

Tumul Chowdhury ◽

Hemanshu Prabhakar ◽

Navdeep Sokhal

Keyword(s):

Normal Saline ◽

Saline Irrigation

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Cold saline irrigation of the renal pelvis during Radiofrequency Ablation of a central renal neoplasm: a case report

Journal of Medical Case Reports ◽

10.1186/1752-1947-2-40 ◽

2008 ◽

Vol 2 (1) ◽

Cited By ~ 6

Author(s):

Jose P Morales ◽

Tarun Sabharwal ◽

Marios Georganas ◽

Renato Dourado ◽

Declan Cahill ◽

...

Keyword(s):

Case Report ◽

Radiofrequency Ablation ◽

Renal Pelvis ◽

Renal Neoplasm ◽

Saline Irrigation ◽

Cold Saline

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Huge sternal chondrosarcoma: a case report

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492318803813 ◽

2018 ◽

Vol 26 (8) ◽

pp. 632-634

Author(s):

Yousef Yousefi ◽

Ali Sadrizadeh ◽

Sepehr Sadrizadeh

Keyword(s):

Computed Tomography ◽

Case Report ◽

Bone Cement ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Muscle Flap ◽

Cartilage Tissue ◽

Prolene Mesh ◽

Core Needle

A 75-year-old man presented very late with a huge sternal mass that measured 91 × 84 mm on computed tomography. A core needle biopsy revealed atypical cartilage tissue, suggesting chondrosarcoma. The mass was resected and the defect was reconstructed with bone cement, Prolene mesh, and a muscle flap.

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