Cement pulmonary embolism after percutaneous vertebroplasty and kyphoplasty: An overview

Novel methodology for assessing biomaterial–biofluid interaction in cancellous bone

“…This type of leakage occurred in 83% of the samples, thus highlighting the importance of monitoring all vertebral walls for cement extravasation through breaches in the cortex to avoid complications and minimize possible life-threatening risks to the patients. This is mainly because leakage into the surrounding vasculature can reach remote areas of the body, such as the lungs, and cause pulmonary embolisms [39][40][41]. The posterior leakage typically observed in the Lesion surrogate was similar to that reported by Reidy et al [31] who studied the cement filling pattern in seven osteoporotic human vertebrae with simulated lytic lesion.…”

Pulmonary Embolism with Vertebral Augmentation Procedures

“…Pulmonary cement embolisms are usually detected incidentally and less than 1% of patients have presented with clinical symptoms, which explains the lack of clarity in understanding the diagnosis and specific management of this clinical condition [13]. Several studies confirm that patients with cement embolism are commonly asymptomatic or present with symptoms of dyspnea for brief periods of time [14–17].…”

“…Some authors have suggested treatment criteria based on the severity of symptoms and location and size of the pulmonary embolism [13, 18]. Among the suggested criteria for treatment, symptomatic patients with peripheral/small emboli should receive conservative treatment with clinical followup and reevaluation, whereas those acute symptomatic patients with central emboli or peripheral emboli should receive treatment with heparin followed by warfarin for 3–6 months [13–18]. In those patients with severe symptoms, severe respiratory failure, and large emboli, aggressive treatment with embolectomy is suggested [18].…”

Vertebroplasty and kyphoplasty: Techniques, complications, and troubleshooting

“…This problem is estimated to occur in 3.5%-23% of the cases, though less than 1% of the affected patients develop symptoms in the form of dyspnea and tachypnea. 20 In this regard, a plain chest x-ray is indicated in all patients, even in those without symptoms, 24 hours after VP or KP. 21…”