FDA Adverse Event Malfunction Summary report: N

CEMENT, BONE, VERTEBROPLASTY

MDR report key: 4156895 · Received October 9, 2014

Report

Report Number
1030489-2014-03989
Event Type
Malfunction
Date Received
October 9, 2014
Report Date
September 11, 2014
Manufacturer
MEDTRONIC SOFAMOR DANEK
Product Code
NDN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

LITERATURE CITATION : CHONGYAN WANG; SHUNWU FAN; JUNHUI LIU; LETU SUYOU; ZHI SHAN; FENGDONG ZHAO. "BASIVERTEBRAL FORAMEN COULD BE CONNECTED WITH INTRAVERTEBRAL CLEFT: A POTENTIAL RISK FACTOR OF CEMENT LEAKAGE IN PERCUTANEOUS KYPHOPLASTY". THE SPINE JOURNAL 14 (2014) 1551-1558. MEAN AGE = 71 YEARS (RANGE, 56-91 YEARS). SEX: 129 WOMEN; 35 MEN. (B)(6). (B)(4). CEMENT EXTRAVASATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT A RETROSPECTIVE STUDY WAS PERFORMED ON 164 PATIENTS TO ASSESS THE INCIDENCE RATE OF DIFFERENT TYPES OF CEMENT LEAKAGE IN PKP (PERCUTANEOUS KYPHOPLASTY PROCEDURES) WITH OR WITHOUT INTRAVERTEBRAL CLEFTS AND TO DETERMINE WHETHER THE BASIVERTEBRAL FORAMEN COULD BE CONNECTED TO THE INTRAVERTEBRAL CLEFT. BETWEEN JANUARY 2009 AND JANUARY 2012, 183 PATIENTS UNDERWENT PKP TO TREAT OVCFS. ALL PATIENTS REPORTED REFRACTORY LOW BACK PAIN AND TENDERNESS, AND FAILED TO RESPOND TO CONSERVATIVE TREATMENT FOR AT LEAST 2 MONTHS. TWO HUNDRED AND FOUR VERTEBRAE IN 164 PATIENTS (129 WOMEN AND 35 MEN) WITH A MEAN AGE OF 71 YEARS (RANGE, 56-91 YEARS) WERE SELECTED FOR THE STUDY. A TOTAL OF 204 VERTEBRAE IN 164 CONSECUTIVE PATIENTS WHO UNDERWENT PKP TO TREAT OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES WERE CLASSIFIED INTO TWO PATTERNS BASED ON PREOPERATIVE RADIOGRAPHS, CT SCANS, AND/OR MR IMAGES OF THE TREATED LEVELS: CLEFT PATTERN (WITH AN INTRAVERTEBRAL CLEFT IN THE VERTEBRAL BODY) AND TRABECULAR PATTERN (WITHOUT INTRA VERTEBRAL CLEFTS). A TRABECULAR PATTERN COULD BE INFERRED IF THE OPAQUE CEMENT WAS INTERSPERSED THROUGHOUT THE TRABECULAR SPACE LIKE A SPONGE. THE OCCURRENCE AND TYPE OF CEMENT LEAKAGE WERE ASSESSED ON POSTOPERATIVE RADIOGRAPHS, CT SCANS, AND/OR MR IMAGES OF THE TREATED LEVELS. THE PATTERNS OF CEMENT LEAKAGE WERE CLASSIFIED INTO FIVE TYPES: TYPE A, THROUGH A CORTICAL DEFECT INTO PARASPINAL SOFT TISSUES; TYPE B, THROUGH THE BASIVERTEBRAL FORAMEN; TYPE C, VIA THE NEEDLE CHANNEL; TYPE D, THROUGH A CORTICAL DEFECT INTO THE DISC SPACE; AND TYPE E, VIA THE PARAVERTEBRAL VEIN. IT WAS REPORTED THAT ASYMPTOMATIC CEMENT EXTRAVASATION THROUGH THE BASIVERTEBRAL FORAMEN (TYPE B) OCCURRED IN 29 VERTEBRAE. TYPE B CEMENT LEAKS REACHED THE SPINAL CANAL, RESULTING IN AN INVERTED Y SHAPE ON POSTOPERATIVE CT SCANS, AND A LONGITUDINAL DISTRIBUTION POSTERIOR TO THE VERTEBRAL BODY ON LATERAL RADIOGRAPHS. NO PATIENT COMPLICATIONS WERE REPORTED IN THE ARTICLE FOR THESE TYPE B CEMENT EXTRAVASATIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
635188 CEMENT, BONE, VERTEBROPLASTY NDN MEDTRONIC SOFAMOR DANEK NA UNK

Patients

Seq Age Sex Outcome Treatment
1 00071 YR KYPHOPLASTY DEVICES