Minimally Invasive Technique for PMMA Augmentation of Fenestrated Screws

Figure 5

Cement extravasations. Postoperative computed tomography scans showing prevertebral ((a), (b)), paravertebral (c), epidural (c), and intradiscal (d) cement extravasations (encircled). Arrows (d) indicate fenestrations in the distal third of the thread; the arrowhead (d) indicates the hollow central shaft of the cannulated screw now filled with PMMA cement. Long screws with the tip of cannulated screws close to the anterior cortex of the vertebra (asterisks) might provoke prevertebral and paravertebral cement extravasations. Notice that the right screw (c) has not been cement-augmented due to local sclerosis of the vertebral body and therefore sufficient primary fixation strength.

(a)

(b)

(c)

(d)