Epidural and Intradural Cement Leakage following Percutaneous Vertebroplasty: A Case Report

Abstract

A 48-year-old woman presented with severe bilateral leg pain, urinary incontinence, and paraparesis following vertebroplasty in another hospital 15 days earlier. Computed tomography and magnetic resonance imaging showed blocks of epidural and intradural cement from T12 to L1 with neurological compression. She underwent corpectomy of L1 and removal of extradural cement, followed by anterior reconstruction with an expandable cage and dual rod-screw construct (Kaneda system). Postoperatively, the patient had minimal improvement in leg pain and neurological deficit. Computed tomographic myelography was therefore performed and revealed complete blockage, which is suspected to be due to intradural cement leakage. The patient underwent posterior durotomy and removal of the cement. Postoperatively, the patient reported immediate pain relief. Her neurological status gradually improved over months. At the 2-year follow-up, the patient was able to walk with support and to perform activities of daily living and had regained her urinary function.