Cement pulmonary embolism as a consequence of vertebroplasty.

摘要

A 58-year-old woman underwent vertebroplasty at a local hospital for treatment of a spontaneous T9 osteoporotic vertebral fracture. She had a systemic autoimmune disease characterized by diffuse polyarthritis and digital vasculitis. Therapy had included a long-term variable dose of cortico-steroids, risedronate (35 mg weekly) and calcium carbonate (600 mg daily). The vertebroplasty was carried out through apercutane-ous transpedicuiar approach with injection of barium-opacified polymethyl-metha cry late cement under fluoro-scopic guidance. Soon after the procedure, the patient complained of marked dyspnoea and severe pleuritic chest pain. Radiological imaging showed evidence of epidural cement leakage (Fig. 1a) and embolized cement within the pulmonary vasculature (Pig. 1b-d).