Migration of fragments into the spinal canal after intervertebral polyethylene glycol implantation: an extremely rare adverse effect

2014 ◽  
Vol 21 (4) ◽  
pp. 614-616 ◽  
Author(s):  
Bekir Akgun ◽  
Sait Ozturk ◽  
Hakan Cakin ◽  
Metin Kaplan
Keyword(s):  
Polyethylene Glycol ◽  
Spinal Canal ◽  
Rare Complication ◽  
Lumbar Vertebrae ◽  
Leg Pain ◽  
Motor Deficit ◽  
Low Back ◽  
Disc Space ◽  
Discogenic Low Back Pain ◽  
The Right

Percutaneous intervertebral hydrogel (polyethylene glycol) implantation is a current treatment procedure that aims to restore hydration of a degenerated disc. There have been a few studies that claim that polyethylene glycol is successful for pain relief as the intervertebral space restores its hydration and elasticity. This procedure is reported to be indicated for discogenic low-back pain and mild radicular pain as it contributes to disc restoration. In this report, the authors describe the case of a 43-year-old woman who was admitted with low-back and right leg pain. Muscle strength in dorsiflexion of the right ankle and right toe was 3/5. The patient had undergone hydrogel implantation for L4–5 intervertebral disc restoration 2 days prior to presentation. There was a significant increase in the patient's complaints after hydrogel implantation, and acute weakness in the right ankle and toe had developed. Magnetic resonance imaging of the lumbar vertebrae, which was performed before the hydrogel implantation, showed a significant narrowing of the L4–5 disc space height, and a disc herniation that extended to the right neural foramen and caused compression of the dural sac. The patient underwent surgery immediately. The sequestered disc fragment that caused a prominent stenosis in the spinal canal, as well as hydrogel fragments, was removed. There was an improvement in the patient's complaints and motor deficit postoperatively. In this paper, a very rare complication is reported. In patients who have increased pain after intervertebral hydrogel implantation and who develop a neurological deficit, the migration of the applied material into the spinal canal should be considered.

Aspergillus meningitis and discitis from low-back procedures in an immunocompetent patient

2007 ◽  
Vol 48 (6) ◽  
pp. 687-689 ◽  
Author(s):  
A. B. Larson Kolbe ◽  
A. M. McKinney ◽  
A. Tuba Karagulle Kendi ◽  
D. Misselt
Keyword(s):  
Steroid Injection ◽  
Rare Complication ◽  
Immunocompetent Patient ◽  
Epidural Steroid Injection ◽  
Low Back ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Epidural Steroid ◽  
The Brain

We present a case of an immunocompetent patient who developed Aspergillus meningitis, subsequent to discitis, presumed to be from an epidural steroid injection. Magnetic resonance imaging (MRI) of the lumbar spine confirmed the diagnosis of discitis. Fluoroscopic-guided aspiration of the disc showed growth of Aspergillus fumigatus. MRI of the brain revealed involvement of the right third cranial nerve. Repeat MRIs demonstrated multiple leptomeningeal masses consistent with granulomatous meningitis. Meningitis is a rare complication of discitis, discogram, or epidural steroid injection. Aspergillus usually only infects immunocompromised patients, but rarely can affect immunocompetent patients.

scholarly journals SALMONELLA OSTEOMYELITIS OF THE LUMBAR SPINE: AN UNUSUAL PRESENTATION IN AN IMMUNOCOMPETENT MALE

2018 ◽  
Vol 11 (1) ◽  
pp. 1
Author(s):  
Aroop Mohanty ◽  
Naveen Pandita ◽  
Pankaj Kandwal ◽  
Balram Ji Omar ◽  
Pratima Gupta ◽  
...  
Keyword(s):  
Rare Complication ◽  
Vertebral Osteomyelitis ◽  
Complete Recovery ◽  
Salmonella Typhi ◽  
Motor Deficit ◽  
Ageing Population ◽  
Low Back ◽  
Antitubercular Drugs ◽  
Wound Culture

  Prevalence of Salmonella vertebral osteomyelitis has increased in recent years due to greater number of spinal surgical procedures, ageing population, and intravenous drug abuse. It is a rare complication of Salmonella infection. We report a case of a 17-year-old male who presented with low back pain for past 1 month. Physical examination revealed spinal tenderness over L2-L5 spine with sensory and motor deficit. Magnetic resonance imaging of dorsolumbar spine showed spondylodiscitis at L2-L5 and epidural collection at L4-L5 level. The patient did not respond to conservative treatment and trial of antitubercular drugs. He underwent open discal biopsy and decompression laminotomy. Intraoperatively, he was found to have epidural abscess and discitis at L3-L4 level. Tissue and wound culture grew Salmonella typhi, and with antibiotic susceptibility guidance, he was treated with intravenous cefuroxime for 4 weeks. On his latest follow-up, there was complete recovery and fusion at diseased vertebrae level.

scholarly journals Alternative strategies for lumbar discectomy: intradiscal electrothermy and nucleoplasty

2002 ◽  
Vol 13 (2) ◽  
pp. 1-6 ◽  
Author(s):  
William C. Welch ◽  
Peter C. Gerszten
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Disc ◽  
Lessons Learned ◽  
Leg Pain ◽  
Low Back ◽  
Disc Disease ◽  
Discogenic Pain ◽  
Discogenic Low Back Pain ◽  
Disc Material

In recent years the general trend in spinal surgery has been one of reductionism and minimalization. A number of techniques have recently been developed that are applicable in the treatment of lumbar disc herniation and discogenic pain due to degenerative disc disease. The purpose of this manuscript is to examine two newer percutaneous disc treatment techniques, intradiscal electrothermal therapy (IDET) anuloplasty and nucleoplasty. The authors review the appropriate clinical treatment criteria, techniques, and lessons learned after performing these procedures in more than 100 patients. The IDET involves the percutaneous insertion of a specially designed thermal resistance probe followed by controlled heating of the intervertebral disc. This may result in disc shrinkage and reduction in pain. The nucleoplasty procedure involves the percutaneous removal of disc material by using a low-temperature resister probe to disintegrate and evacuate disc material, followed by thermal treatment of adjacent residual disc material. To date, no study has been published in which investigators examine the outcomes of this procedure for the treatment of radicular leg pain and low-back pain. Both IDET and nucleoplasty appear to be safe procedures. The IDET procedure may be an alternative to lumbar interbody fusion. Although its long-term role is being defined, this technique appears to provide intermediate-term relief of pain in a population of patients with discogenic low-back pain. Nucleoplasty may provide a percutaneous alternative to microdiscectomy in selected cases.

scholarly journals SALMONELLA OSTEOMYELITIS OF THE LUMBAR SPINE: AN UNUSUAL PRESENTATION IN AN IMMUNOCOMPETENT MALE

2018 ◽  
Vol 11 (1) ◽  
pp. 1
Author(s):  
Aroop Mohanty ◽  
Naveen Pandita ◽  
Pankaj Kandwal ◽  
Balram Ji Omar ◽  
Pratima Gupta ◽  
...  
Keyword(s):  
Rare Complication ◽  
Vertebral Osteomyelitis ◽  
Complete Recovery ◽  
Salmonella Typhi ◽  
Motor Deficit ◽  
Ageing Population ◽  
Low Back ◽  
Antitubercular Drugs ◽  
Wound Culture

  Prevalence of Salmonella vertebral osteomyelitis has increased in recent years due to greater number of spinal surgical procedures, ageing population, and intravenous drug abuse. It is a rare complication of Salmonella infection. We report a case of a 17-year-old male who presented with low back pain for past 1 month. Physical examination revealed spinal tenderness over L2-L5 spine with sensory and motor deficit. Magnetic resonance imaging of dorsolumbar spine showed spondylodiscitis at L2-L5 and epidural collection at L4-L5 level. The patient did not respond to conservative treatment and trial of antitubercular drugs. He underwent open discal biopsy and decompression laminotomy. Intraoperatively, he was found to have epidural abscess and discitis at L3-L4 level. Tissue and wound culture grew Salmonella typhi, and with antibiotic susceptibility guidance, he was treated with intravenous cefuroxime for 4 weeks. On his latest follow-up, there was complete recovery and fusion at diseased vertebrae level.

Efficacy of IDET for Relief of Leg Pain Associated with Discogenic Low Back Pain

Pain Practice ◽  
2004 ◽  
Vol 4 (4) ◽  
pp. 281-285 ◽  
Author(s):  
Richard Derby ◽  
Sang-Heon Lee ◽  
Kwan Sik Seo ◽  
Kerri Kazala ◽  
Byung-Jo Kim ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Leg Pain ◽  
Low Back ◽  
Discogenic Low Back Pain

scholarly journals Endovascular foreign body removal of a MynxGrip polyethylene glycol (PEG) sealant embolus using a cerebral stent retriever

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Mohammed Shamseldin ◽  
Hendrik Bergert ◽  
Axel Neumeister ◽  
Ralf Puls
Keyword(s):  
Polyethylene Glycol ◽  
Foreign Body ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Stent Retriever ◽  
Closure Device ◽  
Vascular Closure Device ◽  
Stent Retrievers ◽  
The Right

Abstract Background This is a rare case of removing an intra-arterial foreign body represented by MynxGrip polyethylene glycol (PEG) sealant as a rare complication of using the MynxGrip™ Vascular Closure Device (AccessClosure, Inc., Mountain View, CA) using a pRESET stent retriever (Phenox, Bochum, Germany) which is utilized mainly for treatment of endovascular stroke. Case presentation A 60-year-old female patient suffering from intermittent claudication in the right lower limb (stage IIb according to Fontaine) due to a peripheral arterial occlusive disease was presented for an elective revascularization using balloon angioplasty of a short chronic occlusion of the right superficial femoral artery. After a successful revascularization of the right superficial femoral artery using a retrograde femoral access from the left common femoral artery, the patient suffered from an acute limb ischemia in the left foot with distal popliteal embolization with involvement of BTK (below the knee) trifurcation. This is believed to be due to an intra-arterial foreign body embolism of MynxGrip polyethylene glycol sealant as a rare complication of using the MynxGrip™ Vascular Closure Device. Conclusions Stent retrievers have been used previously in removing dislocated coils especially in the cerebral vessels. This case report however proves a high efficacy and safety of using stent retrievers in removing different and rather unusual intra-arterial foreign bodies such as MynxGrip polyethylene glycol sealant.

scholarly journals Coflex interspinous implant placement leading to synovial cyst development: case report

2018 ◽  
Vol 29 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Seba Ramhmdani ◽  
Marc Comair ◽  
Camilo A. Molina ◽  
Daniel M. Sciubba ◽  
Ali Bydon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Facet Joint ◽  
Cauda Equina ◽  
Synovial Cyst ◽  
Leg Pain ◽  
Segmental Motion ◽  
Low Back ◽  
The Right ◽  
Lumbar Spinal

Interspinous process devices (IPDs) have been developed as less-invasive alternatives to spinal fusion with the goal of decompressing the spinal canal and preserving segmental motion. IPD implantation is proposed to treat symptoms of lumbar spinal stenosis that improve during flexion. Recent indications of IPD include lumbar facet joint syndrome, which is seen in patients with mainly low-back pain. Long-term outcomes in this subset of patients are largely unknown. The authors present a previously unreported complication of coflex (IPD) placement: the development of a large compressive lumbar synovial cyst. A 64-year-old woman underwent IPD implantation (coflex) at L4–5 at an outside hospital for low-back pain that occasionally radiates to the right leg. Postoperatively, her back and right leg pain persisted and worsened. MRI was repeated and showed a new, large synovial cyst at the previously treated level, severely compressing the patient’s cauda equina. Four months later, she underwent removal of the interspinous process implant, bilateral laminectomy, facetectomy, synovial cyst resection, interbody fusion, and stabilization. At the 3-month follow-up, she reported significant back pain improvement with some residual leg pain. This case suggests that facet arthrosis may not be an appropriate indication for placement of coflex.

scholarly journals BLOCK RESECTION OF LUMBAR OSTEOBLASTOMA. PRESENTATION OF A CASE AND BIBLIOGRAPHICAL UPDATE

2018 ◽  
Vol 17 (4) ◽  
pp. 323-325
Author(s):  
Pedro Luis Bazán ◽  
Richard Avero Gonzalez ◽  
Nicolás Maximiliano Ciccioli ◽  
Enrique Alcides Casco ◽  
Álvaro Enrique Borri ◽  
...  
Keyword(s):  
Lumbar Vertebrae ◽  
Percutaneous Biopsy ◽  
Definitive Treatment ◽  
Motor Deficit ◽  
Lytic Lesion ◽  
Level Of Evidence ◽  
Tumor Margins ◽  
Diagnostic Biopsy ◽  
The Right ◽  
Enneking Stage

ABSTRACT Objective: To present the clinical case and update the bibliography. Methods: A male patient, 24 years of age, sought treatment for right lumbosciatalgia of 3 years of evolution with topography L5 and motor deficit (M4). The radiograph showed a radiopaque lesion between the fourth and fifth lumbar vertebrae, with right pedicle effacement of L4. The tomography identified a lytic lesion, partially surrounded by sclerosis with a central nest of 3 centimeters in diameter located in the right pedicle with involvement of the transverse apophysis and reaction of the intertransverse space (Enneking 3). It was complemented by magnetic resonance and bone scintigraphy. The percutaneous biopsy guided by tomography yielded a diagnosis of osteoblastoma and foci of necrosis. A radical block resection was performed with clear tumor margins and instrumented stabilization. Results: After the surgical treatment, the patient evolved favorably, reversing the motor deficit. The anatomopathological study of the specimen confirms the preoperative diagnosis. Discussion: Intralesional resection may be an option in Enneking stage 2. In Enneking stage 3, a percutaneous diagnostic biopsy may be useful, and block resection is the preferred definitive treatment. Conclusions: The management of spinal osteoblastoma requires an exhaustive clinical-imaging analysis. Block resection with clear margins is preferred in advanced cases for management and to decrease the risk of recurrence. Level of Evidence IV; Case seriesh.

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