Pulmonary embolism of polymethyl methacrylate during percutaneous vertebroplasty and kyphoplasty.
OBJECTIVE
The purpose of this study was to determine the frequency, radiographic findings, and clinical significance of a pulmonary embolism of cement occurring during percutaneous vertebroplasty or kyphoplasty as detected on conventional chest radiography.


METHODS
Chest radiographs were obtained after 69 percutaneous vertebroplasty procedures in 64 patients. Chest radiographs were reviewed retrospectively for the presence of pulmonary emboli of cement, and findings were assessed. The frequency was calculated from the cases treated. Medical records were reviewed for procedure-related complications.


RESULTS
The emboli of cement were noted radiographically in three (4.6%) of 65 procedures performed in our institution. All patients with cement emboli had multiple myeloma. The chest radiographic findings were multiple radiographically dense opacities with a tubular and branching shape that were scattered sporadically or distributed diffusely throughout the lungs. All patients with cement pulmonary embolism remained asymptomatic. A correlation of embolism of cement to lungs was found with paravertebral venous cement leak (p < 0.001) but not with the number of vertebral bodies treated (p = 0.185) or with the type of procedure performed-kyphoplasty versus vertebroplasty (p = 0.98).


CONCLUSIONS
Pulmonary embolism of cement is seen in 4.6% of patients after percutaneous vertebroplasty or kyphoplasty. The characteristic radiographic findings should be recognized by radiologists.
Choe
Du Hwan
DH
Department of Radiology, Box 57, Division of Diagnostic Imaging, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
Marom
Edith M
EM
Ahrar
Kamran
K
Truong
Mylene T
MT
Madewell
John E
JE
D001843:Bone Cements / Q000009:adverse effects* / Q000627:therapeutic use; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000209:etiology*; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D013131:Spine / Q000601:surgery*; D018709:Statistics, Nonparametric
D001843:Bone Cements