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Open Medicine

formerly Central European Journal of Medicine

Editor-in-Chief: Darzynkiewicz, Zbigniew


IMPACT FACTOR 2018: 1.221

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2391-5463
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Volume 8, Issue 5

Issues

Volume 10 (2015)

Late onset of pulmonary cement embolism after a regular vertebroplasy. A clinical documentation

Roger Falkenstern-Ge
  • Division of Pulmonology, Klinik Schillerhoehe, Center for Pulmonology and Thoracic Surgery, Teaching Hospital of the University of Tuebingen, Solitude Str. 18, 70839, Stuttgart-Gerlingen, Germany
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  • De Gruyter OnlineGoogle Scholar
/ Kim Husemann
  • Division of Pulmonology, Klinik Schillerhoehe, Center for Pulmonology and Thoracic Surgery, Teaching Hospital of the University of Tuebingen, Solitude Str. 18, 70839, Stuttgart-Gerlingen, Germany
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  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Martin Kohlhäufl
  • Division of Pulmonology, Klinik Schillerhoehe, Center for Pulmonology and Thoracic Surgery, Teaching Hospital of the University of Tuebingen, Solitude Str. 18, 70839, Stuttgart-Gerlingen, Germany
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  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2013-09-18 | DOI: https://doi.org/10.2478/s11536-013-0207-0

Abstract

Vertebroplasty is a new minimal-invasive procedure for the treatment of painful vertebral fractures. The risk of a pulmonary embolism ranges from 3.5 to 23% for osteoporotic fractures. However, data about the incidence and treatment strategies of pulmonary cement embolisms (PCE) are limited. We report a case of a patient with symptomatic pulmonary cement embolism after the vertebroplasty. The diagnosis was confirmed by means of CT- scan. In cases of asymptomatic patients with peripheral PCE we recommend no treatment besides clinical follow-up. In our case of symptomatic embolisms, we recommend to proceed according to the guidelines regarding the treatment of thrombotic pulmonary embolisms, which includes initial heparinization and a following 6-month coumarin therapy.

Keywords: Vertebroplasty; Kyphoplasty; Complication; Cement leakage; PCE (Pulmonary cement embolism); Polymethylmethacrylate (PMMA)

  • [1] Kim YJ, Lee JW, Park KW, et al. Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures: incidence, characteristics, and risk factors. Radiology. 2009;251:250–259 http://dx.doi.org/10.1148/radiol.2511080854CrossrefGoogle Scholar

  • [2] Hodler J, Peck D, Gilula LA. Midterm outcome after vertebroplasty: predictive value of technical and patient-related factors. Radiology. 2003;227:662–668 http://dx.doi.org/10.1148/radiol.2273011930CrossrefGoogle Scholar

  • [3] Caudana R, Renzi BL, Ventura L, Aitini E, Rozzanigo U, Barai G. CT-guided percutaneous vertebroplasty: personal experience in the treatment of osteoporotic fractures and dorsolumbar metastases. Radiol Med (Torino) 2008;113:114–133 http://dx.doi.org/10.1007/s11547-008-0230-1Web of ScienceCrossrefGoogle Scholar

  • [4] Krueger A, Bliemel C, Zettl R and Ruchholtz S. Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature Eur Spine J. 2009 September; 18(9): 1257–1265 http://dx.doi.org/10.1007/s00586-009-1073-yCrossrefGoogle Scholar

  • [5] Mousavi P, Roth S, Finkelstein J, Cheung G, Whyne C. Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae. J Neurosurg. 2003;99:56–59 Google Scholar

  • [6] Phillips FM, Todd WF, Lieberman I, Campbell-Hupp M. An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine. 2002;27:2173–2178 http://dx.doi.org/10.1097/00007632-200210010-00018CrossrefGoogle Scholar

  • [7] Laredo JD, Hamze B. Complications of percutaneous vertebroplasty and their prevention. Semin Ultrasound CT MR. 2005;26:65–80 http://dx.doi.org/10.1053/j.sult.2005.02.003CrossrefGoogle Scholar

  • [8] Ratliff J, Nguyen T, Heiss J. Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine. 2001;26:E300–E302 http://dx.doi.org/10.1097/00007632-200107010-00021CrossrefGoogle Scholar

  • [9] Bernhard J, Heini PF, Villiger PM. Asymptomatic diffuse pulmonary embolism caused by acrylic cement: an unusual complication of percutaneous vertebroplasty. Ann Rheum Dis. 2003;62:85–86 http://dx.doi.org/10.1136/ard.62.1.85CrossrefGoogle Scholar

  • [10] Padovani B, Kasriel O, Brunner P, Peretti-Viton P. Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty. AJNR Am J Neuroradiol. 1999;20:375–377 Google Scholar

  • [11] Tozzi P, Abdelmoumene Y, Corno AF, Gersbach PA, Hoogewoud HM, Segesser LK. Management of pulmonary embolism during acrylic vertebroplasty. Ann Thorac Surg. 2002;74:1706–1708 http://dx.doi.org/10.1016/S0003-4975(02)03962-0CrossrefGoogle Scholar

  • [12] Yoo KY, Jeong SW, Yoon W, Lee J. Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate. Spine. 2004;29:E294–E297 http://dx.doi.org/10.1097/01.BRS.0000131211.87594.B0CrossrefGoogle Scholar

About the article

Published Online: 2013-09-18

Published in Print: 2013-10-01


Citation Information: Open Medicine, Volume 8, Issue 5, Pages 662–664, ISSN (Online) 2391-5463, DOI: https://doi.org/10.2478/s11536-013-0207-0.

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© 2013 Versita Warsaw. This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License. BY-NC-ND 3.0

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