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Treatment of an osteoporotic vertebral compression fracture with the StaXx FX system resulting in intrathoracic wafers: a serious complication.

van der Plaat LW, Bulstra GH, Albers GH, Eerenberg JP, van der Vis HM - Eur Spine J (2011)

Bottom Line: To report a serious complication of the StaXx FX system used to stabilize an osteoporotic vertebral fracture.A 76-year-old woman presented with a painful vertebral fracture.Treatment by means of a PEEK wafer kyphoplasty was complicated by malposition of the wafers.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Academic Medical Center, Postbus 22660, 1100 DD, Amsterdam, The Netherlands. Lplaat@hotmail.com

ABSTRACT

Purpose: To report a serious complication of the StaXx FX system used to stabilize an osteoporotic vertebral fracture.

Case report: A 76-year-old woman presented with a painful vertebral fracture. Treatment by means of a PEEK wafer kyphoplasty was complicated by malposition of the wafers. The patient recovered fully after removal of the wafers by means of a thoracotomy.

Conclusions: New treatment modalities have their own pitfalls and possible complications, as demonstrated in this case report. Caution regarding implementation of new treatment modalities should be practiced.

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Related in: MedlinePlus

Intra-operative fluoroscopy of malpositioned wafers
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Fig2: Intra-operative fluoroscopy of malpositioned wafers

Mentions: After general anaesthesia and antibiotic prophylaxis (1,000 mg cefamandole) and prone positioning, a K-wire was inserted from a left extrapedicular entry position using fluoroscopy. After measuring the length, the sizer was inserted followed by gently tapping the wafer gun into the vertebra. The device penetrated the anterolateral cortex, and was withdrawn to the correct depth. During insertion of the first few wafers anterolateral protrusion was observed on fluoroscopy. Despite this observation, more wafers were introduced and these seemed to be positioned correctly. However, subsequent wafers again seemed to protrude (Fig. 2), therefore the procedure was terminated. Stabilization of the wafers by adding bone cement was omitted because of potential cement leakage into the thoracic cavity. The patient remained stable, and a direct postoperative X-ray revealed no pneumothorax, thus watchful waiting was performed after consulting a thoracic surgeon.Fig. 2


Treatment of an osteoporotic vertebral compression fracture with the StaXx FX system resulting in intrathoracic wafers: a serious complication.

van der Plaat LW, Bulstra GH, Albers GH, Eerenberg JP, van der Vis HM - Eur Spine J (2011)

Intra-operative fluoroscopy of malpositioned wafers
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369049&req=5

Fig2: Intra-operative fluoroscopy of malpositioned wafers
Mentions: After general anaesthesia and antibiotic prophylaxis (1,000 mg cefamandole) and prone positioning, a K-wire was inserted from a left extrapedicular entry position using fluoroscopy. After measuring the length, the sizer was inserted followed by gently tapping the wafer gun into the vertebra. The device penetrated the anterolateral cortex, and was withdrawn to the correct depth. During insertion of the first few wafers anterolateral protrusion was observed on fluoroscopy. Despite this observation, more wafers were introduced and these seemed to be positioned correctly. However, subsequent wafers again seemed to protrude (Fig. 2), therefore the procedure was terminated. Stabilization of the wafers by adding bone cement was omitted because of potential cement leakage into the thoracic cavity. The patient remained stable, and a direct postoperative X-ray revealed no pneumothorax, thus watchful waiting was performed after consulting a thoracic surgeon.Fig. 2

Bottom Line: To report a serious complication of the StaXx FX system used to stabilize an osteoporotic vertebral fracture.A 76-year-old woman presented with a painful vertebral fracture.Treatment by means of a PEEK wafer kyphoplasty was complicated by malposition of the wafers.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Academic Medical Center, Postbus 22660, 1100 DD, Amsterdam, The Netherlands. Lplaat@hotmail.com

ABSTRACT

Purpose: To report a serious complication of the StaXx FX system used to stabilize an osteoporotic vertebral fracture.

Case report: A 76-year-old woman presented with a painful vertebral fracture. Treatment by means of a PEEK wafer kyphoplasty was complicated by malposition of the wafers. The patient recovered fully after removal of the wafers by means of a thoracotomy.

Conclusions: New treatment modalities have their own pitfalls and possible complications, as demonstrated in this case report. Caution regarding implementation of new treatment modalities should be practiced.

Show MeSH
Related in: MedlinePlus