Clinical Reasoning: a 61-year-old woman with neurogenic shock following percutaneous vertebroplasty
| Autor: | Daniel Agustin Godoy, Ruben Manzi, Carlos Vega Ramírez, Mario Di Napoli, Bladimir Gonzales Ore, Pablo Barra, Erica Alvarez |
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| Rok vydání: | 2012 |
| Předmět: |
Myoclonus
medicine.medical_specialty Vertebroplasty medicine.diagnostic_test Anterior wedging business.industry medicine.medical_treatment Clinical reasoning Shock Neurogenic shock Middle Aged medicine.disease Lateral recess Percutaneous vertebroplasty Vertebral body medicine.anatomical_structure medicine Fluoroscopy Humans Spinal canal Female Neurology (clinical) Radiology business |
| Zdroj: | Neurology. 79(15) |
| ISSN: | 1526-632X |
| Popis: | A 61-year-old woman with a stable traumatic anterior L4 vertebral wedge fracture without spinal canal compromise was referred because of an intense and refractory pain at the level of fracture in spite of maximal medical therapy. MRI scans showed anterior wedging of L4 vertebral body involving the superior endplate with intact posterior wall (figure 1A). Percutaneous vertebroplasty (PV) was indicated for her high surgical risk. Under general anesthesia, right L4 transpedicular PV was performed under X-ray fluoroscopy using polymethylmethacrylate (PMMA; volume injected 3 cm3; SpinePlex®; Kalamazoo, MI). No critical leaks or lesions of the posterior cortex or the lateral recess were identifiable in postprocedure fluoroscopy. Figure 1 Preinterventional, postinterventional, and postoperative neuroradiologic findings (A) Preinterventional T2- (double chevron) and T1- (single chevron) weighted MRI show a chronic anterior wedging of L4 vertebral body … |
| Databáze: | OpenAIRE |
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