ABSTRACT
Herein, the authors describe a case of symptomatic, enzymatically positive pancreatitis secondary to inferior vena cava (IVC) penetration by an IVC filter. Computed tomography revealed evidence of a filter strut in the head of the pancreas. Although caval penetration has been shown to be a complication associated with the use of IVC filters, to the authors' knowledge symptomatic pancreatitis is a rare manifestation of filter penetration.
Subject(s)
Pancreatitis/diagnosis , Pancreatitis/etiology , Vena Cava Filters/adverse effects , Adult , Diagnosis, Differential , Female , HumansSubject(s)
Intervertebral Disc Displacement/therapy , Low Back Pain/etiology , Low Back Pain/therapy , Spinal Fractures/therapy , Humans , Injections, Spinal , Intervertebral Disc Displacement/complications , Intervertebral Disc Displacement/diagnostic imaging , Low Back Pain/epidemiology , Lumbosacral Region , Magnetic Resonance Imaging , Nerve Block , Osteoporosis/complications , Osteoporosis/diagnostic imaging , Radiography, Interventional , Recurrence , Spinal Fractures/complications , Spinal Fractures/diagnostic imaging , Steroids/therapeutic useABSTRACT
PURPOSE: To determine the efficacy and durability of percutaneous vertebroplasty for the treatment of back pain associated with vertebral body compression fractures. MATERIALS AND METHODS: One hundred patients (79 women, 21 men; mean age, 73.7 y) underwent 156 percutaneous injections of polymethylmethacrylate (PMMA) into a vertebra (68 thoracic and 88 lumbar) under fluoroscopic guidance over a 35-month period. Before the procedure and at follow-up, patients were asked to quantify their pain on a visual analog scale (VAS) and complete a follow-up questionnaire of our own design. RESULTS: The procedure was technically successful in all patients. There were two complications. One patient sustained a sternal fracture and one experienced a transient radiculopathy. Ninety-seven patients (97%) reported significant pain relief 24 hours after treatment. Mean follow-up duration was 21.5 months (6-44 mo) in 99 patients. Ninety-two patients (93%) reported significant improvement in back pain previously associated with their compression fractures as well as improved ambulatory ability. Before vertebroplasty, the VAS score for the 99 patients was 8.91 +/- 1.12 compared to a score of 2.02 +/- 1.95 at follow-up. The mean difference in VAS scores was significant (P <.0001). CONCLUSION: Percutaneous vertebroplasty of symptomatic vertebral body compression fractures is a minimally invasive procedure that provides immediate and sustained pain relief in patients with refractory pain.
