PMC4419214_01
(a) Preinterventional STIR MRI showing acute D8, D10, L2, and L4 vertebral body fracture (red arrows). (b) Postoperative axial CT scan showing epidural cement leakage into the right epidural space at the L2 vertebral level (yellow arrows). (c) Postoperative sagittal CT scan showing epidural cement leakage into the right epidural space at the L2 vertebral level (yellow arrow). Minimal leakage is seen at T8 level (red arrow). (d) Postoperative axial T1, (e) sagittal T1 contrast MRI, showing enhancement of nerve roots along cauda equina (red arrows), signalling meningeal irritation.
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fig1
T8, T10, L2, and L4 osteoporotic compression fractures confirmed by hyperintense signal in STIR sequence at MRI (Figure 1(a)) was treated with PV at T8, T10, L2, and L4 level because of refractory pain after 4 weeks of conservative treatment. The procedure was done under general anesthesia, using polymethylmethacrylate (PMMA; volume injected 3 cm3; Ava-Tex (Cardinal-Health Inc., Dublin, OH, USA)) in our orthopaedic department. On further investigation computer tomography (CT) of the spine showed epidural cement leakage into the right epidural space at the L2 vertebral level (Figures 1(b) and 1(c)).