Reperfusion Revision Surgery for Augmented Vertebral Nonunion with Movable Cement.

Abstract

Osteoporotic vertebral nonunion is a special type of osteoporotic vertebral fracture and can gain satisfactory clinical outcomes using vertebral augmentation. In the rare occurrence that augmented vertebral nonunion occurs postoperatively, pedicle screw fixation is the primary strategy. However, is a different method like the second shot of cement reliable? The purpose of this study is to introduce the reperfusion revision surgery strategy for treatment of osteoporotic vertebral nonunion. An 80-year-old female patient experienced vertebral re-nonunion in situ after receiving kyphoplasty at the T11 vertebrae. During revision surgery, we tried a new, minimally invasive surgical method in which we inserted cement into the intravertebral cleft around the movable cement without obvious leakage. Special bone cement perfusion techniques (incremental temperature cement delivery and secondary cement preparation based-perfusion and blocking) were used. The cement tail was performed to increase the anchor and fastness between the cement and vertebral body. The patient gained immediate pain relief and vertebral stability after the revision surgery. A 2-year postoperative radiograph and follow-up showed sufficient vertebral height and clinical outcomes. Using special puncture and bone cement perfusion techniques, reperfusion revision surgery in situ is an effective strategy for the treatment of vertebral re-nonunion.