Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty

D’Errico, Stefano; Niballi, S.; Bonuccelli, Diana

doi:10.1016/j.jflm.2019.03.004

Cited by 30 publications

(23 citation statements)

References 37 publications

(34 reference statements)

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“… 4 8) Cement leakage can occur as a complication of cement augmentation and cause local complications and systemic complications such as cerebral embolism, cardiac embolism, pulmonary embolism, renal artery embolism, and acute respiratory distress syndrome. 2 6 7 10 11 13 14 15) The mechanisms of cement leakage have not been analyzed yet, but it could be estimated. First, the intravetebral cleft would be a tract of cement leakage.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Perforation Caused by Bone Cements as a Complication of Cement Augmented Pedicle Screw Fixation Using the Fenestrated Pedicle Screw: A Case Report

Hong

Jeon

et al. 2020

Korean J Neurotrauma

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Cement-augmented fenestrated pedicle screw fixation is becoming more popular for osteoporotic patients. Although several reports have been published on leakage-related problems with bone cement, no cases of cardiac perforation after cement-augmented pedicle screw fixation have been reported. We present a case of cardiac perforation after cement-augmented fenestrated pedicle screw fixation. A 67-year-old female was admitted to our hospital with complaints of dyspnea and chest pain after lumbar surgery. She had been treated with L4–5 lumbar interbody fusion and percutaneous pedicle screw fixation with bone cement augmentation seven days earlier for degenerative spondylolisthesis. The right chest pain was observed a day after the surgery; she was treated conservatively but it did not improve for 7 days after surgery. Chest computed tomography (CT) revealed a hemothorax and a large sharp bone cement fragment that perforated the right atrium. Bone cement can be removed with thoracotomy surgery. We have to be aware of cement leakage through the normal venous drain system around the vertebral body. We also have to consider a detailed cardiac workup, which may include chest CT or echocardiography, if a patient complains of chest pain or dyspnea after cement augmentation.

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Section: Discussionmentioning

confidence: 99%

Cardiac Perforation Caused by Bone Cements as a Complication of Cement Augmented Pedicle Screw Fixation Using the Fenestrated Pedicle Screw: A Case Report

Hong

Jeon

et al. 2020

Korean J Neurotrauma

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“…Reimer et al reported that 66% of PTCL patients were able to proceed to SCT consolidation. All 55 patients kept their response following transplantation and the 3-year OS and PFS rates were 48% and 36%, respectively (22) . CHOEP followed by high dose therapy and SCT was reported to be effective for ALKnegative PTCL patients, with 5-year PFS and OS rates of 44% and 51%, respectively (23) .…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Peripheral T-Cell Lymphoma Patients: Single Center ‘Real-Life’ Experience

Ozbalak¹,

Mastanzade²,

Özlük³

et al. 2020

BMJ

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Objective: Peripheral T-cell lymhomas (PTCLs) represent a heterogeous group of diseases, with poor long-term outcomes excluding ALK+ anaplastic large cell lymphoma (ALCL). Method: We represent data of our retrospective analysis of 62 consecutive PTCL cases diagnosed since 2002. Median observation time was 16 months. Results: The overall response rate to first line treatment was 53 percent. Data related to median progression- free survival and overall survival times could not be obtained for ALK+ALCL group whereas median progression- free survival and overall survival times for ALK-negative ALCL group were 1 and 18 months, respectively. Disease progression was frequently observed histologically in ALK-negative group. For ALKnegative ALCL, advanced stage disease was defined as the presence of serum albumin <3.4 g/dl, serum total protein ≤6.2 g/dl, high serum LDH, and serum ferritin >200 ng/ml, presence of B symptoms, and extranodal involvement of more than one site. Risk factors associated with death were serum albumin <3.4 g/dl, serum total protein ≤6.2 g/dl, serum ferritin over 200 ng/ml, and bone marrow involvement at the time of diagnosis. During follow-up 39 patients (64%) died. Most common reasons were progressive disease and infections. Four patients developed secondary malignancies. Conclusion: Our study is a reflection of the ‘real-life’. Three patients died due to disease progression shortly after diagnosis without providing treatment due to aggressiveness of the disease. Alternatives to CHOP-based chemotherapies should be found for the ALK + non-anaplastic large cell lymphoma group.

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“…Fortunately, two (9%) of the patients could be treated with minimally invasive endovascular retrieval; however, most patients were treated with open surgery (19, 86.4%). One patient could not receive any treatment due to sudden death and cardiac perforation by a cement embolus was found during an autopsy 6) .…”

Section: Discussionmentioning

confidence: 99%

Cardiac Perforation Caused by Cement Embolus after Cement-Augmented Pedicle Screw Instrumentation: A Case of Report

Kim

Park

Lee

et al. 2020

J Minim Invasive Spine Surg Tech

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Cement-augmented pedicle screw instrumentation (CAPSI) is a widely used surgical technique in posterior spondylodesis of osteoporotic patients. Complications related to cement leakage after CAPSI was rarely reported compare to that of vertebroplasty, kyphoplasty and most of them are asymptomatic. Herein the authors report the case of a 67-year-old female who experienced cardiac perforation by string shape cement embolus after CAPSI. She underwent the foreign body removal operation through the 5 th intercostal thoracotomy and she was well recovered consequently. Surgeons should be aware of this complication entity when encounter postoperative chest pain to avoid fatal results. The authors also reviewed the case reports for cardiac perforation by cement embolus and preventive modalities for the cement leakage.

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Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty

Cited by 30 publications

References 37 publications

Cardiac Perforation Caused by Bone Cements as a Complication of Cement Augmented Pedicle Screw Fixation Using the Fenestrated Pedicle Screw: A Case Report

Cardiac Perforation Caused by Bone Cements as a Complication of Cement Augmented Pedicle Screw Fixation Using the Fenestrated Pedicle Screw: A Case Report

Retrospective Analysis of Peripheral T-Cell Lymphoma Patients: Single Center ‘Real-Life’ Experience

Cardiac Perforation Caused by Cement Embolus after Cement-Augmented Pedicle Screw Instrumentation: A Case of Report

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