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HOME > J Trauma Inj > Volume 28(3); 2015 > Article
Pulmonary Bone Cement Embolism Following Percutaneous Vertebroplasty
Yong Han Cha
Journal of Trauma and Injury 2015;28(3):202-205
Published online: September 30, 2015
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Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Received: 23 April 2015   • Revised: 23 April 2015   • Accepted: 23 April 2015

Pulmonary cement embolization after vertebroplasty is a well-known complication. The reported incidence of pulmonary cement emboli after vertebroplasty ranges frome 2.1% to 26% with much of this variation resulting from which radiographic technique is used to detect embolization. Onset and severity of symptoms are variable.
DESCRIPTION: We present the case of a 83-year-old women who underwent fourth lumbar vertebroplasty and subsequently had dyspnea several days later. Posteroanterior chest radiography showed multiple linear densities. Computed tomography of thorax revealed also multiple bilateral, linear hyperdensities within the lobar pulmonary artery branches are detected in axial and coronal views. LITERATURE REVIEWS: Operative management of vertebral compression fractures has included percutaneous vetebroplasty for the past 25 years. Symptoms of pulmonary cement embolism can occur during procedure, but more commonly begin days to weeks, even months, after vertebroplsty. Most cases of pulmonary cement emboli with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation. Endovascular removal of large cement emboli from the pulmonary arteries is not without risk and sometimes requires open surgery for complete removal of cement pieces.
Pulmonary cement embolism is a potentially serious complication of vertebroplasty. If a patient has chest pain or respiratory difficulty after the procedure, chest radiography and possibly advanced chest imaging studies should be performed immediately.

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