[Percutaneous vertebroplasty for vertebral compression fractures in the patient with acute lymphoblastic leukemia].

Percutaneous vertebroplasty (PVP) is an interventional treatment for painful vertebral compression fractures caused by osteoporosis and malignant diseases such as multiple myeloma and metastatic bone tumors. We present the first case of PVP performed on a man in his thirties with vertebral compression fractures secondary to acute lymphoblastic leukemia. PVP at T11 and L1 levels resulted in a marked improvement in refractory pain although he developed delayed pyogenic spondylitis two months after the intervention. This case suggests that PVP could be one of the useful therapeutic procedures for intractable back pain associated with vertebral compression fractures in acute lymphoblastic leukemia if we are extremely vigilant for the risk of spondylitis.

[Ultrasound guided T2 intercostal nerve block: a comparison with stellate ganglion block under the blind technique and ultrasound guided technique].

BACKGROUND: The aim of this study is to compare the efficacy of stellate ganglion block, performed by ultrasound guided technique and blind technique, and ultrasound guided T2 intercostal nerve block. METHODS: In the present study, we evaluated the changes in upper arm skin temperature, and the development of Horner syndrome after stellate ganglion block (blind technique and ultrasound guided technique) and ultrasound guided T2 intercostal nerve block in 12, 11 and 10 patients scheduled for each block. Stellate ganglion blocks (blind technique) were performed via an anterior paratracheal approach at C6 using 1% mepivacaine 5 ml. Ultrasound guided stellate ganglion blocks were performed using 8-5 MHz, curved array transducer, and 1% mepivacaine 5 ml is injected to the longus colli muscle at C6 by the out of plane technique. Ultrasound guided intercostal nerve blocks were performed using 13-6 MHz, linear array transducer, and 0.75% ropivacaine 5 ml at T2. Patients were examined before and after the procedure. RESULTS: There were no significant differences in the increase of skin temperature and the development of Horner syndrome between the groups. CONCLUSIONS: Compared to stellate ganglion block (blind technique), ultrasound guided stellate ganglion block and T2 ultrasound-guided intercostal nerve block provided a similar efficacy.