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Acute Paraplegia After Vertebroplasty Caused by Epidural HemorrhageA Case Report
Christof Birkenmaier, MD1; Sebastian Seitz, MD1; Bernd Wegener, MD1; Christian Glaser, MD1; Maximilian I. Ruge, MD1; Alessandro von Liebe, MD1; Christoph von Schulze Pellengahr, MD1
1 Departments of Orthopedic Surgery (C.B., S.S., B.W., A.v.L., and C.v.S.P.), Clinical Radiology (C.G.), and Neurosurgery (M.I.R.), Grosshadern Medical Center, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany. E-mail address for S. Seitz: stardustseeker@web.de
The Journal of Bone & Joint Surgery.  2007; 89:1827-1831  doi:10.2106/JBJS.F.01612
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Extract

Vertebroplasty is widely used for the palliative stabilization of osteoporotic fractures and vertebral metastases. Serious complications with this procedure are rare and, as a result, vertebroplasty is being performed increasingly in hospitals without a spinal surgery unit or even in radiology practices where such complications may not be managed adequately when they arise. The leakage of cement into draining veins is the most frequent complication1,2, followed by cement penetration into the spinal canal. Fatal pulmonary embolism has been reported, and small cement emboli are not uncommon1,3. When cement penetration into the spinal canal causes a neurological deficit, decompression and often removal of the cement are required. The case of a patient who had an epidural hematoma after kyphoplasty associated with the postoperative administration of an intravenous heparin bolus has been described4. We report the case of a patient who had an acute epidural hemorrhage causing paraplegia as a complication from vertebroplasty. To the best of our knowledge, this is the first such report. The patient was informed that data concerning the case would be submitted for publication.
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