Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature Review

Introduction. Acrylic cement pulmonary embolism is a potentially serious complication following vertebroplasty. Case Report. A 70-year-old male patient was treated with percutaneous vertebroplasty for osteoporotic nontraumatic vertebral collapse of L5-S1. Asymptomatic pulmonary cement embolism was d...

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Main Authors: Girolamo Geraci, Giorgio Lo Iacono, Chiara Lo Nigro, Fabio Cannizzaro, Massimo Cajozzo, Giuseppe Modica
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2013/591432
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author Girolamo Geraci
Giorgio Lo Iacono
Chiara Lo Nigro
Fabio Cannizzaro
Massimo Cajozzo
Giuseppe Modica
author_facet Girolamo Geraci
Giorgio Lo Iacono
Chiara Lo Nigro
Fabio Cannizzaro
Massimo Cajozzo
Giuseppe Modica
author_sort Girolamo Geraci
collection DOAJ
description Introduction. Acrylic cement pulmonary embolism is a potentially serious complication following vertebroplasty. Case Report. A 70-year-old male patient was treated with percutaneous vertebroplasty for osteoporotic nontraumatic vertebral collapse of L5-S1. Asymptomatic pulmonary cement embolism was detected on routine postoperative chest radiogram and the patient was treated with enoxaparin, amoxicillin, and dexamethasone. At the followup CT scan no further migration of any cement material was reported; and the course was uneventful. Discussion. The frequency of local leakage of bone cement is relatively high (about 80–90%), moreover, the rate of cement leakage into the perivertebral veins (seen in up to 24% of vertebral bodies treated) with consequent pulmonary cement embolism varies from 4.6 to 6.8% (up to 26% in radiologic studies); the risk of embolism is increased with the liquid consistency of the cement and with the treatment of some malignant lesions. Patients may remain asymptomatic and develop no known long-term sequelae. Conclusions. Our ancedotal case illustrates the need for close monitoring of patients undergoing percutaneous vertebroplasty and emphasizes the importance of prompt and correct diagnosis and treatment, even if actually there is no agreement regarding the therapeutic strategy.
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issn 2090-6900
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publishDate 2013-01-01
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series Case Reports in Surgery
spelling doaj-art-53cb02ef4db442e7a6fb4f8f8485ecaa2025-08-20T03:36:22ZengWileyCase Reports in Surgery2090-69002090-69192013-01-01201310.1155/2013/591432591432Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature ReviewGirolamo Geraci0Giorgio Lo Iacono1Chiara Lo Nigro2Fabio Cannizzaro3Massimo Cajozzo4Giuseppe Modica5Section of General and Thoracic Surgery, University of Palermo, Via Liborio, Giuffrè 5, 90124 Palermo, ItalySection of General and Thoracic Surgery, University of Palermo, Via Liborio, Giuffrè 5, 90124 Palermo, ItalySection of General and Thoracic Surgery, University of Palermo, Via Liborio, Giuffrè 5, 90124 Palermo, ItalySection of General and Thoracic Surgery, University of Palermo, Via Liborio, Giuffrè 5, 90124 Palermo, ItalySection of General and Thoracic Surgery, University of Palermo, Via Liborio, Giuffrè 5, 90124 Palermo, ItalySection of General and Thoracic Surgery, University of Palermo, Via Liborio, Giuffrè 5, 90124 Palermo, ItalyIntroduction. Acrylic cement pulmonary embolism is a potentially serious complication following vertebroplasty. Case Report. A 70-year-old male patient was treated with percutaneous vertebroplasty for osteoporotic nontraumatic vertebral collapse of L5-S1. Asymptomatic pulmonary cement embolism was detected on routine postoperative chest radiogram and the patient was treated with enoxaparin, amoxicillin, and dexamethasone. At the followup CT scan no further migration of any cement material was reported; and the course was uneventful. Discussion. The frequency of local leakage of bone cement is relatively high (about 80–90%), moreover, the rate of cement leakage into the perivertebral veins (seen in up to 24% of vertebral bodies treated) with consequent pulmonary cement embolism varies from 4.6 to 6.8% (up to 26% in radiologic studies); the risk of embolism is increased with the liquid consistency of the cement and with the treatment of some malignant lesions. Patients may remain asymptomatic and develop no known long-term sequelae. Conclusions. Our ancedotal case illustrates the need for close monitoring of patients undergoing percutaneous vertebroplasty and emphasizes the importance of prompt and correct diagnosis and treatment, even if actually there is no agreement regarding the therapeutic strategy.http://dx.doi.org/10.1155/2013/591432
spellingShingle Girolamo Geraci
Giorgio Lo Iacono
Chiara Lo Nigro
Fabio Cannizzaro
Massimo Cajozzo
Giuseppe Modica
Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature Review
Case Reports in Surgery
title Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature Review
title_full Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature Review
title_fullStr Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature Review
title_full_unstemmed Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature Review
title_short Asymptomatic Bone Cement Pulmonary Embolism after Vertebroplasty: Case Report and Literature Review
title_sort asymptomatic bone cement pulmonary embolism after vertebroplasty case report and literature review
url http://dx.doi.org/10.1155/2013/591432
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AT chiaralonigro asymptomaticbonecementpulmonaryembolismaftervertebroplastycasereportandliteraturereview
AT fabiocannizzaro asymptomaticbonecementpulmonaryembolismaftervertebroplastycasereportandliteraturereview
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