Pulmonary and Renal Cement Embolisms During Balloon Kyphoplasty - A Case Report -

Chung-Shik Shin; Byeong-Yeol Choi

doi:10.4184/jkss.2015.22.2.65

Journal List > J Korean Soc Spine Surg > v.22(2) > 1076079

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Shin and Choi: Pulmonary and Renal Cement Embolisms During Balloon Kyphoplasty - A Case Report -

Case Report

Journal of Korean Spine Surg 2015;22(2):65-68.

Published online: 21 June 2015

DOI: https://doi.org/10.4184/jkss.2015.22.2.65

Pulmonary and Renal Cement Embolisms During Balloon Kyphoplasty - A Case Report -

Chung-Shik Shin, M.D., Byeong-Yeol Choi, M.D.

Departments of Orthopedic Surgery, Presbyterian Medical Center, Jeonju, Korea

Corresponding author: Byeong-Yeol Choi, M.D. Department of Orthopedic Surgery, Presbyterian Medical Center 365, Seowon-ro, Wansan-gu, Jeonju 561-750, Korea TEL: +82-63-230-8744, FAX: +82-63-230-1439 E-mail: docby@hanmail.net

Received 5 December 2014 Revised 10 March 2015 Accepted 11 June 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A case report.

Objectives

To report a case of simultaneous pulmonary and renal embolisms after balloon kyphoplasty and review relevant literature.

Summary of Literature Review

Pulmonary or renal embolism caused by cement leakage during balloon kyphoplasty is a rare complication but can be fatal.

Materials and Methods

An 84-year-old female patient was treated with balloon kyphoplasty for an osteoporotic compression fracture. Pulmonary and renal embolisms were detected after the procedure and the patient was treated conservatively.

Results

After conservative treatment, embolism-related symptoms were not found during the followup period.

Conclusions

We encountered a case of simultaneous pulmonary and renal cement embolisms which occurred during kyphoplasty. This is a very rare but potentially serious complication. However, the patient had no longterm sequelae after conservative treatment.

Keywords: Spine, Compression fracture, Pulmonary embolism, Renal embolism, Kyphoplasty

REFERENCES

1. Amar AP, Larsen DW, Esnaashari N, et al. Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery. 2001; 49:1105–14.

2. Deramond H, Depriester C, Galibert P, et al. Percutaneous vertebroplasty with polymethylmethacrylate: technique, in-dications, and results. Radiol Clin North Am. 1998; 36:533–46.

3. Radcliff KE1, Reitman CA, Delasotta LA, et al. Pulmonary cement embolization after kyphoplasty: a case report and review of the literature. Spine J. 2010; 10:E1–5.

4. Yoo KY, Jeong SW, Yoon W, et al. Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate. Spine (Phila Pa 1976). 2004; 29:E294–7.

5. Hulme PA, Krebs J, Ferguson SJ, et al. Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine (Phila Pa 1976). 2006; 31:1983–2001.

6. Eck JC, Nachtigall D, Humphreys SC, et al. Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J. 2008; 8:488–97.

7. Hiwatashi A, Sidhu R, Lee RK, et al. Kyphoplasty versus vertebroplasty to increase vertebral body height: a cadevaric study. Radiology. 2005; 237:1115–9.

8. Krueger A, Bliemel C, Zettl R, et al. Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systemic review of the literature. Euro-pean. Eur Spine J. 2009; 18:1257–65.

9. Habib N, Maniatis T, Ahmed S, et al. Cement pulmonary embolism after percutaneous vertebroplasty and kyphoplasty: an overview. Heart Lung. 2012; 41:509–11.

10. Kollmann D, Hoetzenecker K, Prosch H, et al. Removal of a large cement embolus from the right pulmonary artery 4 years after kyphoplasty: consideration of thrombogenicity. J Thorac Cardiovasc Surg. 2012; 143:E22–4.

Fig. 1.

The T1 weighted sagittal magnetic resonance (MR) image of the lumbar spine shows compression fractures at L2, 3 with decreased marrow signal intensity.

Fig. 2.

Sagittal T1-weighted MR image shows new adjacent vertebral fracture on L4 (arrow).

Fig. 3.

An immediate postoperative radiograph shows cement leakage into the paravertebral venous system and right lung area (arrow) but there's no obvious radiopaque material in the kidney.

Fig. 4.

Computed tomography (CT) demonstrates the presence of radiodense cement material in the segmental pulmonary arteries of the right posterior lung (arrow) (A) and in the renal vein and interlobar renal vein of the right kidney (arrow) (B).

TOOLS

Similar articles