Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: a report of three cases.
METHODS
Three cases of pulmonary embolism caused by polymethylmethacrylate (PMMA) after percutaneous vertebroplasty are reported, and the literature is reviewed.


OBJECTIVE
To report on three cases of pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty, and to review the literature briefly for reduction of this complication.


BACKGROUND
Pulmonary embolus caused by polymethylmethacrylate during percutaneous vertebroplasty is a rare complication. However, there is always a potential risk of this complication, which may result in pulmonary infarction.


METHODS
Three of 27 patients with malignant spinal tumor experienced pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty. Cement migration into the venous channel was observed in two patients, but not during the procedure. Two patients had mild dyspnea and chest discomfort, and one was asymptomatic. Pulmonary embolism was confirmed on chest radiographs. Ventilation perfusion scanning was performed to detect perfusion defect in all cases.


RESULTS
Ventilation perfusion scanning showed no perfusion defects in any case. The symptoms of dyspnea and chest discomfort in two patients subsided after treatment using supplemental oxygen inhalation and anticoagulants.


CONCLUSIONS
Three cases of pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty are reported. Proper techniques can minimize the risk of pulmonary embolism caused by poly-methylmethacrylate during percutaneous vertebroplasty.
Jang
Jee Soo
JS
Wooridul Spine Hospital, Seoul, Korea. spinejjs@yahoo.co.kr
Lee
Sang Ho
SH
Jung
Sang Ki
SK
D000925:Anticoagulants / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology / Q000628:therapy; D004333:Drug Administration Routes; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications; D010102:Oxygen Inhalation Therapy; D019904:Polymethyl Methacrylate / Q000008:administration & dosage / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D016103:Spinal Fractures / Q000628:therapy; D013131:Spine / Q000187:drug effects / Q000601:surgery
D000925:Anticoagulants; D019904:Polymethyl Methacrylate