Asymptomatic cement leakage into inferior vena cava

Zhao, Zhongtao; Qin, De-An; Zhao, Wenli

doi:10.1093/qjmed/hcab285

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…The only sign that can predict the development of a pulmonary cement embolism fluoroscopic evidence of cement leakage to the azygos vein or vena cava durin vertebroplasty (Figures 4 and 5). Bone cement extravasates toward the vertebral venou plexus which is connected to the azygos system by which it reaches the inferior vena cav the right cardiac chamber, and finally the pulmonary arterial system which may lead to potentially fatal pulmonary embolism [23,24]. A symptomatic pulmonary embolism following vertebroplasty can manifest through either the migration of cement or the migration of fat and bone marrow cells.…”

Section: Venous System Cement Leakage and Pulmonary Embolismmentioning

confidence: 99%

“…It is imperative to initiate early detection and prompt management even in the absence of clinical signs. Should respiratory symptoms emerge post vertebroplasty, a meticulous evaluation for potential pulmonary cement embolism is warranted [ 23 , 24 ]. In situations where the cement advances into the right ventricle, yet proves too lengthy and rigid to traverse the pulmonary artery, it may lodge in the heart and give rise to cardiac perforation—a truly uncommon complication of vertebroplasty, with only a single case documented in the literature.…”

Section: Extravasation Of Cementmentioning

confidence: 99%

“…A preoperative check of inflammatory parameters and MRI should be mandatory. Persistent severe pain, new severe pain of a different character, signs of spinal canal stenosis, or sudden onset of respiratory symptoms should be sent to emergency diagnostics to exclude complications and start treatment if necessary [ 1 , 23 , 24 ].…”

Section: Reducing the Risk And Effects Of Complicationsmentioning

confidence: 99%

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Complications of Percutaneous Vertebroplasty: A Pictorial Review

Cavka,

Delimar,

Rezan

et al. 2023

Medicina

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Percutaneous vertebroplasty is a minimally invasive treatment technique for vertebral body compression fractures. The complications associated with this technique can be categorized into mild, moderate, and severe. Among these, the most prevalent complication is cement leakage, which may insert into the epidural, intradiscal, foraminal, and paravertebral regions, and even the venous system. The occurrence of a postprocedural infection carries a notable risk which is inherent to any percutaneous procedure. While the majority of these complications manifest without symptoms, they can potentially lead to severe outcomes. This review aims to consolidate the various complications linked to vertebroplasty, drawing from the experiences of a single medical center.

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Section: Venous System Cement Leakage and Pulmonary Embolismmentioning

confidence: 99%

Section: Extravasation Of Cementmentioning

confidence: 99%

Section: Reducing the Risk And Effects Of Complicationsmentioning

confidence: 99%

See 1 more Smart Citation

Complications of Percutaneous Vertebroplasty: A Pictorial Review

Cavka,

Delimar,

Rezan

et al. 2023

Medicina

View full text Add to dashboard Cite

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The significance of the best puncture side bone cement/vertebral volume ratio to prevent paravertebral vein leakage of bone cement during vertebroplasty: a retrospective study

Gao¹,

Chen²,

Li³

et al. 2023

BMC Musculoskelet Disord

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Objectives To verify the clinical significance of the best puncture-side bone cement/vertebral volume ratio (PSBCV/VV%) and bone cement leakage in paravertebral veins during vertebroplasty. Methods This was a retrospective analysis of a total of 210 patients from September 2021 to December 2022, who were divided into an observation group (110 patients) and a control group (100 patients). In the observation group, patients’ preoperative computed tomography (CT) data were imported into Mimics software, and the VV was calculated using the three-dimensional (3D) reconstruction function. Then, based on the best PSBCV/VV% of 13.68% determined in a previous study, the optimal PSBCV to be injected during vertebroplasty was calculated. In the control group, vertebroplasty was performed directly using the conventional method. The incidence of cement leakage into paravertebral veins was observed postoperatively in both groups. Results There were no statistically significant differences (P > 0.05) in the evaluated indicators between the two groups pre- or postoperatively, including the anterior vertebral margin height, mid-vertebral height, injured vertebral Cobb angle, visual analogue scale (VAS) score, and Oswestry Disability Index (ODI). Intragroup comparisons showed improvements in the anterior vertebral height, mid-vertebral height, injured vertebral Cobb angle, VAS score, and ODI after surgery compared with before surgery (P < 0.05). In the observation group, there were 3 cases of cement leakage into the paravertebral veins, for a leakage rate of 2.7%. In the control group, there were 11 cases of cement leakage into the paravertebral veins, for a leakage rate of 11%. The difference in the leakage rate between the two groups was statistically significant (P = 0.016). Conclusion In vertebroplasty, preoperative VV calculations using Mimics software, combined with calculation of the PSBCV according to the best PSBCV/VV% (13.68%), can effectively prevent leakage of bone cement into paravertebral veins and further prevent serious life-threatening complications such as pulmonary embolism.

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