scholarly journals Cement venogram as a harbinger of methacrylate embolism after kyphoplasty: A case series

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110412
Author(s):  
Peter J Szachowicz ◽  
Thomas J Gross
Keyword(s):  
Pulmonary Embolism ◽  
Respiratory Symptoms ◽  
Case Series ◽  
Vertebral Compression Fractures ◽  
Intractable Pain ◽  
Intracardiac Shunt ◽  
Compression Fractures ◽  
Cement Embolism ◽  
Institutional Experience ◽  
Cause Of Pain

Vertebral compression fractures remain an important cause of pain and debility. Intractable pain may be approached with vertebral kyphoplasty. We herein present a case of symptomatic pulmonary cement embolism following kyphoplasty. Discovery of a paravertebral cement venogram at the time of this procedure prompted a case series review of our institutional experience with kyphoplasty. We found that cement embolization, whether symptomatic or discovered incidentally, was universally associated with a cement venogram at the site of vertebroplasty. We propose that a cement venogram be viewed as a harbinger of cement pulmonary embolism and this possibility be considered in patients with an existing intracardiac shunt or who present with new respiratory symptoms soon after kyphoplasty.

scholarly journals Vertebroplasty and kyphoplasty: complementary tecniques for the treatment of painful osteoporotic vertebral compression fractures

2009 ◽  
Vol 8 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Alessio Lovi ◽  
Marco Teli ◽  
Alessandro Ortolina ◽  
Francesco Costa ◽  
Maurizio Fornari ◽  
...  
Keyword(s):  
Bone Biopsy ◽  
Treatment Algorithm ◽  
Vertebral Compression Fractures ◽  
Intractable Pain ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Complementary Techniques ◽  
Similar Good ◽  
A Prospective Study

OBJECTIVE: in a prospective study, we aimed to evaluate the potential use of kyphoplasty (KP) and vertebroplasty (VP) as complementary techniques in the treatment of painful osteoporotic vertebral compression fractures (VCFs). METHODS: after one month of conservative treatment for VCFs, patients with intractable pain were offered treatment with KP or VP according to a treatment algorithm that considers time from fracture (Ät) and amount of Vertebral Body Collapse (VBC). Bone biopsy was obtained intraoperatively to exclude patients affected by malignancy or osteomalacia. RESULTS: hundred and sixty-four patients were included according to the above criteria. Mean age was 67.6 years. Mean followup was 33 months. Ten patients (6.1%) were lost to follow-up and 154 reached the minimum two years follow-up. 118 (69.5%) underwent VP and 36 (30.5%) underwent KP. Complications affected five patients treated with VP, whose one suffered a transient intercostal neuropathy and four a subsequent VCF (two at adjacent level). Results in terms of VAS and Oswestry scores were not different among treatment groups. CONCLUSION: in conclusion, at an average follow-up of almost 3 years from surgical treatment of osteoporotic VCFs, VP and KP show similar good clinical outcomes and appear to be complementary techniques with specific different indications.

Pulmonary cement embolism: a complication of percutaneous vertebroplasty

2007 ◽  
Vol 48 (8) ◽  
pp. 854-859 ◽  
Author(s):  
C. Duran ◽  
M. Sirvanci ◽  
M. Aydoğan ◽  
E. Ozturk ◽  
C. Ozturk ◽  
...  
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Imaging Finding ◽  
Early Stage ◽  
Chest Radiographs ◽  
Vertebral Compression Fractures ◽  
Common Procedure ◽  
Compression Fractures ◽  
Branching Patterns ◽  
Cement Embolism

Background: Percutaneous vertebroplasty (PV) has recently become a very common procedure for vertebral compression fractures. Extravasation of cement, a common event associated with vertebroplasty, may lead to cement emboli in the lungs. Purpose: To determine the frequency of pulmonary cement embolism after percutaneous vertebroplasty. Material and Methods: Between 2002 and 2006, 128 percutaneous vertebroplasties were performed in 73 patients (56 women and 17 men) in our institution. Postprocedural chest radiographs were obtained for all patients and assessed for the presence of pulmonary cement emboli. Results: Pulmonary cement embolism was detected on chest radiographs and confirmed with chest computed tomography (CT) in four patients treated with percutaneous vertebroplasty for osteoporotic collapse and one patient treated for multiple myeloma. The imaging finding of pulmonary cement embolism was solitary or multiple fine radiodense lines with occasional branching patterns. The frequency of pulmonary cement embolism was 6.8%. Conclusion: An incidence of pulmonary cement embolism of 6.8% during PV was found. Close clinical follow-up, postprocedural chest radiographs, and chest CT scans, if necessary, are important for the detection of pulmonary cement embolism at an early stage.

scholarly journals Percutaneous Image-Guided Vertebral Fixation in Cancer-Related Vertebral Compression Fractures: A Case Series Study

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 907
Author(s):  
Francois H. Cornelis ◽  
Leo Razakamanantsoa ◽  
Mohamed Ben Ammar ◽  
Milan Najdawi ◽  
Francois Gardavaud ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Case Series ◽  
Lumbar Vertebrae ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Pain Scores ◽  
Case Series Study ◽  
Adjacent Fractures ◽  
Series Study

Background and objectives: Cancer-related vertebral compression fractures (VCF) may cause debilitating back pain and instability, affecting the quality of life of cancer patients. To further drive cement deposition during vertebroplasty, the aims of this restrospective case series study were to report the feasibility, safety and short term efficacy (≤6 months) of percutaneous vertebral fixation in cancer-related vertebral compression fractures using various intravertebral implants. Methods: All consecutive cancer patients treated with percutaneous vertebral fixation for VCF were retrospectively included. Various devices were inserted percutaneously under image guidance and filled by cement. Descriptive statistics were used and a matched paired analysis of pain scores was performed to assess for changes following interventions. Results: A total of 18 consecutive patients (12 women (66.6%) and 6 men (33.3%); mean age 59.7 ± 15.5 years) were included. A total of 42 devices were inserted in 8 thoracic and 16 lumbar vertebrae. Visual analogue scale measurement significantly improved from 5.6 ± 1.8 preoperatively to 1.5 ± 1.7 at 1 week (p < 0.01) and to 1.5 ± 1.3 at 6 months (p < 0.01). No severe adverse events were observed, but three adjacent fractures occurred between 1 week and 5 months after implantation. Conclusions: Percutaneous vertebral fixation of cancer-related VCF is feasible and safe and allows pain relief.

Percutaneous tissue debulking and cement augmentation for advanced malignant vertebral compression fractures

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9535-9535
Author(s):  
B. Georgy ◽  
W. Wong
Keyword(s):  
Bone Cement ◽  
Vertebral Body ◽  
Vertebral Compression Fractures ◽  
Intractable Pain ◽  
Compression Fractures ◽  
Complication Risk ◽  
Relieve Pain ◽  
Cortical Defect ◽  
Cement Extravasation ◽  
Oncologic Treatment

9535 Background: Percutaneous cement injection procedures (eg vertebroplasty, kyphoplasty) are used successfully to palliate patients with painful osteoporotic vertebral compression fractures (VCFs). When VCFs occur because of malignant lesions however, treatment can be challenging; often by the time symptoms occur, the tumor has extended into the epidural tissue and is associated with posterior cortical disruption. As a result, patients have a higher likelihood of cement extravasation outside the vertebral body, thought to be associated with increased complication risk. This study was to investigate clinical viability and effectiveness of a technique designed to improve control of bone cement placement over standard methods when treating patients with symptomatic VCFs caused by malignancy. Methods: All patients had intractable pain determined to be associated with VCFs caused by metastasized malignancy. The procedure involved using a plasma-mediated radiofrequency-based device to debulk tissue and etch a void within the affected vertebral body and then filling the void and adjacent interstices with bone cement to stabilize the vertebral body and relieve pain. Results: 28 patients (36 vertebral bodies) with various types of metastatic lesions were treated. No evidence of cement extravasation outside the vertebral boundary was detected in 34/36 (94%) cases, even in cases with severe posterior cortical compromise and prominent epidural involvement pre-operatively. In the 2 observed cases, cement extravasation was clinically inconsequential. All treated patients reported marked pain relief. No patients were prevented from continuing other oncologic treatments. Conclusions: Tissue removal to create a void before injecting bone cement into a vertebral body compromised by malignancy may reduce the complication rate observed when injecting cement. This technique may redirect cement away from the spinal canal, notably in cases with posterior cortical defect and epidural extension, while also improving interdigitation of cement and decreasing risk of metastatic embolization. The resulting palliation potentially improves functionality and quality of life during and does not appear to affect the effectiveness of continued oncologic treatment. [Table: see text]

scholarly journals Pulmonary Artery Cement Embolism after a Vertebroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Anas Nooh ◽  
Fahad H. Abduljabbar ◽  
Ahmed H. Abduljabbar ◽  
Peter Jarzem
Keyword(s):  
Pulmonary Embolism ◽  
Minimally Invasive ◽  
Vertebral Compression Fracture ◽  
Incidental Finding ◽  
Rare Complication ◽  
Compression Fracture ◽  
Invasive Procedure ◽  
Vertebral Compression Fractures ◽  
Minimally Invasive Procedure ◽  
Cement Embolism

Background Context. Vertebroplasty is a minimally invasive procedure most commonly used for the treatment of vertebral compression fractures. Although it is relatively safe, complications have been reported over time. Among those complications, massive cement pulmonary embolism is considered a rare complication. Here we report a case of massive diffuse cement pulmonary embolism following percutaneous vertebroplasty for a vertebral compression fracture.Study Design. Case report.Methods. This is a 70-year-old female who underwent vertebroplasty for T11 and T12 vertebral compression fracture.Results. CT-scan revealed an incidental finding of cement embolism in the pulmonary trunk and both pulmonary arteries. Since the patient was asymptomatic, she was monitored closely and she did not need any intervention.Conclusion. Vertebroplasty is a minimally invasive procedure used for treatment of vertebral compression fracture. Despite the low rate of complications, a pulmonary cement embolism can occur. The consequences of cement embolism range widely from being asymptomatic to embolism that can cause paralysis, radiculopathy, or a fatal pulmonary embolism.

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