An analysis of the causes of transient paraplegia during percutaneous vertebral augmentation under local anesthesia: A case series of 12 patients

Abstract

Background: Percutaneous vertebral augmentation (PVA) under local anesthesia has been widely used to treat osteoporotic vertebral compression fractures and vertebral body tumors. However, the occurrence of spinal cord or nerve root dysfunction may result in poor prognosis for patients. The aim of this study was to analyze the causes of transient paraplegia in 12 patients undergoing PVA. Methods: The medical records of 12 patients with transient paraplegia during PVA in our hospital were analyzed. Data, including operation, vertebral, anesthetic dose, operation time, recovery time, and follow-up, were extracted. Results: Among the 12 patients, ranging in age from 62 years to 83 years, with a mean age of 74 years, 8 were females and 4 were males. The average anesthetic dose injected per vertebral body was 6.38 ml. Patients required an average of 218.75 min to recover sensation and movement completely. However, the amount of anesthetic injected into each vertebral body was not related to the time required for complete recovery. Follow-up showed that all patients had regained normal bilateral sensation and motor function. Postoperative visual analog scale and Oswestry Disability Index values of the 12 patients were significantly improved compared with preoperative values. Conclusion: The complication of transient paraplegia was caused by local anesthetic drugs infiltrating into the spinal canal and inhibiting nerve conduction in the spinal cord.