PMC7648559_01
Although the L1 and L2 vertebra are wedge shaped at the T2 weighted imaging of magnetic resonance imaging (MRI) (A), the high signal of the short time inversion recovery (STIR) sequence was only seen in the L1 vertebral body (B). Twelve hours after the PKP, a high signal aggregation in front of the spinal cord from T12 to L1 was detected at the sagittal ((C), red arrow) plane of MRI examination, which gathered in the left part of the spinal canal at the axial plane of MRI ((D), red arrow).
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The lumbar magnetic resonance imaging (MRI) showed a L1 and L2 compression fracture; the high signal of the short time inversion recovery (STIR) sequence was seen in the L1 vertebral body (Figure 1A and B). The patient was transferred to our hospital and underwent an emergency MRI examination, which revealed a high signal aggregation in front of the spinal cord from T12 to L1, indicating spinal cord compression (Figure 1C and D).
At the biplane monitoring, the puncture (A, B), balloon dilatation (C, D), and cement injection (E, F) were performed stepwise. Notably, when the needle arrived at the posterior wall of the vertebral body in the sagittal plane of fluoroscopic view, the intraoperative puncture revealed extension of the puncture needle beyond the inner edge of the projection of the pedicle in the coronal plane, suggesting a large abduction angle of the needle (A, B).
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The puncture, balloon dilatation, and cement injection were performed using intraoperative fluoroscopy (Figure 2A-F).
No intraspinal cement leakage was obvious on the anteroposterior (A) and lateral (B) view of the postoperative lumbar radiograph.
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No intraspinal cement leakage was obvious on the postoperative lumbar radiograph (Figure 3) and computed tomography (CT) (Figure 4).
While there was no obvious intraspinal cement leakage on the postoperative lumbar computed tomography, there is visible dispersion of the bone cement on the left side of the vertebral body along the puncture trajectory, whose extension line is medial to the inner wall of the pedicle.
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No intraspinal cement leakage was obvious on the postoperative lumbar radiograph (Figure 3) and computed tomography (CT) (Figure 4).