椎體成形術導致之馬尾症候群下背痛手術併發症案例報告

Cauda Equina Syndrome After Kyphoplasty-A surgical complication for lower back pain

以椎體成形術治療骨質疏鬆所造成的壓迫性骨折長久以來被認為其效果顯著。有可能的手術併發症包括骨水泥外洩，肺栓塞等等。然而，因椎體成形術造成骨折塊向後突出導致椎管壓迫的案例卻少有討論。在這篇論文中，我們提出一個椎體成形術後，向後移位的骨折塊壓迫椎管導致馬尾症候群的案例報告。經由這個案例，我們瞭解到執行椎體成形術前，針對壓迫性骨折病人之神經學檢查與影像學評估其術後造成椎管狹窄之併發症風險是非常重要的。

Kyphoplasty with bone cement injection for osteoporotic spinal compression fractures is proved to be effective. The possible complications of this procedure include cement leakage, pulmonary embolism and others. However, spinal canal compromise by retropulsed bony fragments is less discussed. In this report, we present a case who developed delayed onset of cauda equine syndrome after kyphoplasty. We found out that it was caused not by cement leakage but the retropulsed bony fragments. Through this case, we learned that detailed pre-operative neurological examination and image study for the pre-existing spinal canal stenotic lesion can never be over-emphasized.