Incidence of Pulmonary Cement Embolism after Real-Time CT Fluoroscopy–guided Vertebroplasty

Potet, Julien; Weber-Donat, Gabrielle; Curis, Emmanuel; Arnaud, François-Xavier; Thome, A.; Valbousquet, L.; Peroux, É.; Geffroy, Y.; Bouzad, C.; Kervella, Yann; Lahutte, M.; Ukkola-Pons, E.; Baccialone, J.; Tériitéhau, C.

doi:10.1016/j.jvir.2013.05.048

Cited by 17 publications

(12 citation statements)

References 19 publications

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“…Intraoperative vertebroplasty was accurate and visual to inject bone cement. In our study, cement extravasation was only detected in 1 case, but with no clinical significance (10%).This was overtly lower than PVP (51%) [ 25 ]. According to our experience, it was important that the cement injection was under high viscosity, with intraoperative fluoroscopy and preoperative evaluation of the integrity of the vertebral endplates and posterior wall of the vertebrae.…”

Section: Discussionmentioning

confidence: 52%

Posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for metastatic involvement of the axis

Tan

et al. 2018

BMC Musculoskelet Disord

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BackgroundMetastases to the upper cervical spine were rarely reported in the literature. However, metastases to this area may cause spinal instability and cord compression, which in turn can result in respiratory failure and neurological dysfunction. The present study investigated the efficacy and safety of posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for this disease.MethodsThis was a retrospective study that included 10 patients with metastatic involvement of the axis from March 2002 to May 2014. All cases presented with occipitocervical pain: 5 patients with compressive myelopathy and 6 patients with radiculopathy. Japanese Orthopedic Association (JOA) scores and Visual Analogue Scale (VAS) were used to evaluate the improvement of neurological function and pain intensity, respectively.ResultsAll patients underwent posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty. The VAS scores and JOA scores both improved postoperatively, from 8.2 ± 0.4 to 2.3 ± 0.2 and from 10.1 ± 2.2 to 14.2 ± 2.9, respectively. Additionally, the improvement rate of JOA was 52.4 ± 1.8%. The mean overall survival was 12.8 months. The median survival time was 7 months. The 6-month and 12-month survival rates were 70% and 40%, respectively. The mean duration of operation was 182 min and blood loss was 450 mL. The mean volume of bone cement injected was 4.0 mL. The cement extravasation was observed in only 1 patient without clinical symptoms. One patient developed tumour recurrence and died 1 month later.ConclusionsPosterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty was a safe and valuable palliative method with relatively less invasion to treat metastatic involvement of the axis.

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Section: Discussionmentioning

confidence: 52%

Posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for metastatic involvement of the axis

Tan

et al. 2018

BMC Musculoskelet Disord

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“… 9 Real-time CT guidance during vertebroplasty has proven to be superior to conventional fluoroscopy guidance. 10 Finally, we suggest that all symptomatic patients with a history of vertebroplasty should have a CT chest and echocardiography performed and managed accordingly.…”

Section: Discussionmentioning

confidence: 98%

Acute right atrial and pulmonary artery bone cement mass emboli following vertebroplasty

Diab

Diab²,

Dihmis³

et al. 2016

JRSM Open

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“…Some studies have recommended injecting cement in stages, stopping after injecting a small volume of cement, even if leakage is not observed, and continuing after a 20–30 seconds interval [ 1 14 ]. Some have suggested intravertebral venography prior to the PMMA injection or injection of sclerosing agents into the vertebral bodies to close the venous channels; however, their use is controversial [ 14 21 22 ].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Embolism from Cement Augmentation of the Vertebral Body

Ignacio

2018

Asian Spine J

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Pulmonary cement embolism (PCE) can follow cement augmentation procedures for spine fractures due to osteoporosis, traumatic injuries, and painful metastatic lesions. PCE is underreported and it is likely that many cases remain undiagnosed. Risk factors for PCE have been identified, which can help alert clinicians to patients likely to develop the condition, and there are recommended techniques to reduce its incidence. Most patients with PCE are asymptomatic or only develop transient symptoms, although a few may exhibit florid cardiorespiratory manifestations which can ultimately be fatal. Diagnosis is mainly by radiographic means, commonly using simple radiographs and computed tomography scans of the chest with ancillary tests that assess the patient's cardiorespiratory condition. Management depends on the location and size of the emboli as well as the patient's symptomatology. The aim of this review is to raise awareness of the not uncommon complications of PCE following vertebral cement augmentation and the possibility of serious sequelae. Recommendations for the diagnosis and management of PCE are presented, based on the most recent literature.

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Incidence of Pulmonary Cement Embolism after Real-Time CT Fluoroscopy–guided Vertebroplasty

Cited by 17 publications

References 19 publications

Posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for metastatic involvement of the axis

Posterior decompression and occipitocervical fixation followed by intraoperative vertebroplasty for metastatic involvement of the axis

Acute right atrial and pulmonary artery bone cement mass emboli following vertebroplasty

Pulmonary Embolism from Cement Augmentation of the Vertebral Body

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