Renal cement embolism during percutaneous vertebroplasty.
Percutaneous vertebroplasty (PVP) is an effective treatment for lesions of the vertebral body that involves a percutaneous injection of polymethylmethacrylate (PMMA). Although PVP is considered to be minimally invasive, complications can occur during the procedure. We encountered a renal embolism of PMMA in a 57-year-old man that occurred during PVP. This rare case of PMMA leakage occurred outside of the anterior cortical fracture site of the L1 vertebral body, and multiple tubular bone cements migrated to the course of the renal vessels via the valveless collateral venous network surrounding the L1 body. Although the authors could not explain the exact cause of the renal cement embolism, we believe that physicians should be aware of the fracture pattern, anatomy of the vertebral venous system, and careful fluoroscopic monitoring to minimize the risks during the PVP.
Chung
Seung-Eun
SE
Department of Diagnostic Radiology, Wooridul Spine Hospital, Seoul, Republic of Korea. eunrad@dreamwiz.com
Lee
Sang-Ho
SH
Kim
Tae-Hong
TH
Yoo
Kwang Hyun
KH
Jo
Byung-June
BJ
D001843:Bone Cements / Q000009:adverse effects* / Q000627:therapeutic use; D004617:Embolism / Q000175:diagnosis / Q000209:etiology*; D005548:Foreign-Body Migration / Q000150:complications* / Q000209:etiology; D050723:Fractures, Bone / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000293:injuries; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D054854:Vertebroplasty / Q000009:adverse effects*
D001843:Bone Cements; D019904:Polymethyl Methacrylate