Kyphoplasty is the correction of the height in the bodies with the application of mechanical expansion and the application of surgical cement.
The complications of the technique are very scarce (less than 10%) and most of them are transitory depending mainly on the extravasation of the cement outside the vertebral body. It has been demonstrated a location outside the vertebral body in less than 20% of the performed kyphoplasty.
Local migrations (paravertebral, intradiscal, intraspinal) and migrations of cement from a distance (venous embolisms that reach the pulmonary filter) have been described.
The possibilities of cement extravasation depend on several factors such as training, perfect visualization, the cortical integrity of the vertebral body, the volume of injected cement, its viscosity and whether the cementing is performed on osteoporotic (less risky) or tumoral vertebrae (higher risk). Most cement leaks are not accompanied by clinical symptoms and are not of practical importance, but some cases of root compression have been described in the region of the conjunction hole, caused by the emissary veins engorged by the cement. A case of acute paraplegia after vertebroplasty has been detected. The anti-inflammatory treatment is usually sufficient and only exceptionally it has been necessary a surgical decompression. In patients with a significant reduction in lung function, special care must be taken to avoid the migration of cement through the vein. Overall, complications with clinical repercussions do not exceed 2% of treated patients or 1% of treated vertebrae.
The following are predictive factors of increased risk:
-Vertebral fractures that extend to the posterior area of the vertebra, or a vertebral fragment that extends to the area of the spinal canal.
-Radiculopathy, or irritation of a nerve root in the area of the fracture that often causes areas of paresthesia, tingling, or weakness in the leg.
-Alteration of hemostasis.
-Osteoporosis or any degree of alteration of bone mineral density.