Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: case report.
Paradoxical cerebral embolism of cement occurred in a 78-year-old woman after cement-assisted transpedicular spinal fixation surgery. Multiple pulmonary emboli of polymethylmethacrylate precipitated pulmonary hypertension and right-to-left shunting into the systemic circulation through a patent foramen ovale. This rare complication occurred because of failure to recognize venous migration of cement during the procedure and the injection of multiple levels in one setting. Although this was an open procedure, the technical aspects were the same as for vertebroplasty and the precautions should be applied to percutaneous vertebroplasty.
Scroop
Rebecca
R
Department of Neuroradiology, Flinders Medical Center, Flinders Drive, Bedford Park, SA, Australia.
Eskridge
Joseph
J
Britz
Gavin W
GW
D000368:Aged; D001843:Bone Cements / Q000009:adverse effects* / Q000627:therapeutic use; D020878:Device Removal; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D007278:Injections, Spinal; D020766:Intracranial Embolism / Q000139:chemically induced* / Q000000981:diagnostic imaging; D007431:Intraoperative Complications; D009984:Orthopedic Fixation Devices; D019904:Polymethyl Methacrylate / Q000008:administration & dosage / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000139:chemically induced / Q000150:complications / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D013123:Spinal Fusion; D013131:Spine / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D001843:Bone Cements; D019904:Polymethyl Methacrylate