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A Rare Presentation of Subacute Progressive Ascending Myelopathy Secondary to Cement Leakage in Percutaneous Vertebroplasty

Bhide, Rohit Prakash DNB; Barman, Apurba MD; Varghese, Shiela Mary MD; Chatterjee, Ahana MD; Mammen, Suraj MD; George, Jacob DNB; Thomas, Raji MD

American Journal of Physical Medicine & Rehabilitation: May 2014 - Volume 93 - Issue 5 - p 431–436
doi: 10.1097/PHM.0000000000000028
Case Report

ABSTRACT Percutaneous vertebroplasty is used to manage osteoporotic vertebral body compression fractures. Although it is relatively safe, complications after vertebroplasty ranging from minor to devastatingly major ones have been described. Cement leakage into the spinal canal is one such complication. Subacute progressive ascending myelopathy is an infrequent neurologic complication after spinal cord injury, typically presenting as ascending neurologic deficit within weeks after the initial insult. The precise cause of subacute progressive ascending myelopathy still remains an enigma, considering the rarity of this disorder. The authors present the case of a 62-yr-old woman with osteoporotic vertebral fracture who underwent percutaneous vertebroplasty and developed T6 complete paraplegia because of cement leakage. A few weeks later, the neurologic level ascended to higher cervical level (C3). To date, no case of subacute progressive ascending myelopathy secondary to cement leakage after percutaneous vertebroplasty has been reported. Literature is reviewed regarding subacute progressive ascending myelopathy, and the rehabilitation challenges in the management of this patient are discussed.

From the Department of Physical Medicine & Rehabilitation (RPB, AB, SMV, AC, JG, RT) and Department of Radio-diagnosis (SM), Christian Medical College, Vellore, Tamil Nadu, India.

All correspondence and requests for reprints should be addressed to: Rohit Prakash Bhide, DNB, Department of Physical Medicine & Rehabilitation, Christian Medical College, Vellore, 632004, Tamil Nadu, India.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins