title: Bone cement implantation syndrome during spinal surgery requiring cardiac surgery.
abstract: During a posterior segmental spinal fusion procedure, a 71-year-old woman developed cardiac and pulmonary embolism characterized by nonsustained ventricular tachycardia during cement injection, rapid and severe hypoxemia, and hemodynamic instability. Management included exploratory cardiotomy under cardiopulmonary bypass and removal of the emboli from the pulmonary vessels. Postoperative recovery was successful, and the patient was discharged without sequelae. We discuss the pathophysiology of bone cement implantation syndrome during spinal fusion, possible causative factors, and treatment alternatives.
authors.affiliation: From the *Department of Anesthesiology and Pain Clinic, Complejo Asistencial Universitario de Salamanca, Salamanca; †Department of Anesthesiology, Complejo Asistencial Universitario de Ávila, Ávila; and ‡Department of Cardiovascular Surgery, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Sastre
authors.forename: Teresa
authors.initials: T
authors.lastname: López
authors.forename: María J
authors.initials: MJ
authors.lastname: Dalmau
authors.forename: Rafael E
authors.initials: RE
authors.lastname: Cuello