Cause Analysis of Open Surgery Used After Percutaneous Vertebroplasty and Kyphoplasty

BACKGROUND The aim of this study was to analyze reasons why open surgery was done after percutaneous vertebroplasty and kyphoplasty. MATERIAL AND METHODS Patients (587 vertebral bodies) treated with percutaneous vertebroplasty or kyphoplasty in the Xi'an Honghui Hospital of Shanxi Province from January 2008 to January 2012 were retrospectively analyzed and 13 patients were enrolled in the study. These 13 patients had serious adverse events after percutaneous vertebroplasty or kyphoplasty. Their average age was 64.5 years old. Nine patients had spinal cord injury and 4 had nerve root injury. All the patients underwent open surgery within 4-12 h after definitive diagnosis. RESULTS All 13 cases were followed up (average time 14.1 months, range 3-47 months). Reasons for open surgery included cement extravasation (6 cases, 46.2%), puncture mistake (3 cases, 23.1%), and false selection of indications (4 cases, 30.8%). At last follow-up, skin feeling was better than that before open surgery in 4 cases with nerve root injury, and muscle strength recovered to grade 5 (3 cases) and grade 4 (1 case). In 9 cases with spinal cord injury, 7 patients improved and 2 remained at the same ASIA level. CONCLUSIONS The main reasons for open surgery after percutaneous vertebroplasty and kyphoplasty were cement extravasation (the most common reason), puncture mistake, and false selection of indications.