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Retained Curved Needle After Balloon Kyphoplasty: A Complication with a Novel Device and Its Management

机译:球囊后凸成形术后保留弯曲的针头:一种新型装置的并发症及其处理

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摘要

To date, no case studies specifically describing a curved kyphoplasty needle becoming lodged in the vertebral body with the inability to be withdrawn have been reported. We describe a case involving a single level balloon kyphoplasty with a curved coaxial needle during which the cement delivery device could not be removed after cavity filling. In this case, a board-certified interventional pain management specialist was performing balloon kyphoplasty for an L2 osteoporotic vertebral compression fracture. The tools utilized in this procedure included flexible curved instruments designed to traverse the vertebral body and achieve uniform cement distribution through a unipedicular approach. Cannulation and cavity formation were completed without issue. Upon conclusion of cement filling, the curved cement delivery device was unable to be removed. After several attempts to remove the needle and consultation with both the device company and local spine surgeons, it was agreed that the device should be cut at the level of entry into the pedicle and left as a retained foreign object. The involved area was surgically exposed, the retained instrument was cut flush to the pedicle, and the free portion was removed without further complication. The patient followed up in clinic several months later without evidence of neurologic complications. Considerations when using a curved kyphoplasty device and a method of resolution when faced with the inability to remove such an instrument are discussed.
机译:迄今为止,尚无关于具体描述弯曲后凸成形术针因无法撤回而留在椎体内的病例研究的报道。我们描述了一种案例,该案例涉及用弯曲的同轴针进行单级球囊后凸成形术,在该情况下,在腔填充后无法移除水泥输送装置。在这种情况下,由董事会认证的介入疼痛管理专家正在对L2骨质疏松性椎体压缩性骨折进行球囊后凸成形术。在此过程中使用的工具包括设计成可穿过椎体并通过单椎弓根法实现均匀的水泥分布的柔性弯曲器械。插管和腔体形成完全没有问题。水泥填充结束后,弯曲的水泥输送装置无法拆除。在几次尝试拔出针头并与器械公司和当地脊柱外科医生协商后,同意在进入椎弓根的位置切开器械,并保留其作为异物。手术切除受累区域,将保留的器械切成与椎弓根齐平,并除去自由部分而无进一步的并发症。几个月后,患者在诊所随访,没有神经系统并发症的迹象。讨论了使用弯曲后凸成形术设备时的注意事项以及在无法移除此类器械时的解决方法。

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