title: Detection of pulmonary cement embolism after balloon kyphoplasty : should conventional radiographs become routine?
abstract: Fatal pulmonary cement embolism is the worst complication after balloon kyphoplasty. Therefore the authors conducted a prospective study about the use of postoperative plain radiographs of the chest as a screening tool for the detection of pulmonary cement embolism. More specifically, they tried to determine its incidence. Postoperative AP and lateral plain radiographs of the chest confirmed this diagnosis in only one out of 94 patients (1%). Systematic use of CT would probably have led to a higher incidence. To the authors' knowledge this is the only study assessing the incidence of pulmonary cement embolism after balloon kyphoplasty. Computed tomography confirmed the diagnosis in the single patient affected , but she remained asymptomatic. Given the low incidence, routine postoperative plain radiographs of the chest do not seem to be indicated in asymptomatic patients, although the radiation exposure is low. Reasonable suspicion (dyspnea, peroperative findings via image amplifier) warrants computed tomography for confirmation of the diagnosis.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany. bliemel@med.uni-marburg.de
authors.forename: Christopher
authors.initials: C
authors.lastname: Bliemel
authors.forename: Benjamin
authors.initials: B
authors.lastname: Buecking
authors.forename: Johannes
authors.initials: J
authors.lastname: Struewer
authors.forename: Eike Immo
authors.initials: EI
authors.lastname: Piechowiak
authors.forename: Steffen
authors.initials: S
authors.lastname: Ruchholtz
authors.forename: Antonio
authors.initials: A
authors.lastname: Krueger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001843:Bone Cements; D005260:Female; D006801:Humans; D058498:Kyphoplasty / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000209:etiology*; D011859:Radiography
chemical_list: D001843:Bone Cements