Fig 5.

Symptomatic T1–T2 foraminal cement leak. Extensive breast cancer metastatic lytic lesion of the T1 vertebral body with a large cortical erosion of the posterior wall (arrow on A). Vertebral augmentation was performed under fluoroscopic guidance (B); despite inherently poor visibility in the lateral view of the cervicothoracic junction, the epidural leak was promptly recognized (arrow on B) and cement injection was halted. Nevertheless, the strategically located right foraminal PMMA leak (arrows on C and D) caused a permanent motor deficit of the T1 myotome.