Acute respiratory failure associated with polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty

Treatment of repeated and multiple new-onset osteoporotic vertebral compression fractures with teriparatide

“…Many serious complications with this procedure have been reported, including: leakage of, or acute respiratory failure associated with, polymethyl methacrylate; radiculopathy; spinal cord compression; pedicle fracture; pulmonary embolism intra-arterial thrombus; aortic aneurysm; aortic embolism of cement; pyogenic spondylitis; epidural and subdural cement leakage; posterior spinal epidural abscess; and infected vertebroplasty. [13][14][15][16][17][18][19][20] Although the procedure has a quite high success rate in providing immediate and significant pain relief, Yang et al reported that 22 patients with PVP required revision surgery upon presentation of new symptoms postoperatively. 21 The major complication rate associated with PVP is less than 1%, but 16.6% of patients experienced new-onset VCF after PVP during the 24-78-month follow-up period in our previous studies.…”

Pulmonary Cement Embolization After Vertebroplasty Requiring Pulmonary Wedge Resection

“…Some patients who experience pulmonary cement embolism are asymptomatic [34,35,43]. A pulmonary cement embolism can present with arrhythmia, hypotension, hypoxia, dry cough, progressive dyspnea, or chest pain [19,22,24,31,57]. Acute respiratory distress syndrome also can be caused by a pulmonary cement embolism [56].…”

“…Most cases of pulmonary cement embolism with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation [19,24,31,37,39,50,57]. Krueger et al [29] proposed a management algorithm that includes observation for peripheral asymptomatic embolisms, anticoagulation therapy for patients with either a symptomatic peripheral embolism or an asymptomatic central embolism, and surgical intervention for symptomatic central embolisms only.…”

“…Operative management of vertebral compression fractures has included percutaneous vertebroplasty for the past 25 years. Although pulmonary cement emboli after percutaneous vertebroplasty occur in as many as 26% of patients [53], most of these patients are asymptomatic and are treated nonoperatively with anticoagulation [19,24,31,37,39,50,57], although rarely, open cardiovascular surgery is needed to remove large cardiopulmonary emboli [13]. Symptoms of pulmonary cement emboli can occur during the procedure, but more commonly symptoms occur later, sometimes weeks or months after the procedure [1,9,13,22,33,35,48].…”

Pulmonary Palacos Embolism: A Case Report

“…Serious vasodilatation in the small pulmonary circulation and micro embolisms may also appear in the lungs. These mechanisms are capable of causing serious complications, including ARDS [9]. However, Urbanyi et al was unable to demonstrate a relationship between the thermal and toxic effect of cement and subsequent vessel damage in an animal model [10].…”