European Spine Journal

, Volume 18, Issue 9, pp 1257–1265 | Cite as

Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature

  • Antonio KruegerEmail author
  • Christopher Bliemel
  • Ralph Zettl
  • Steffen Ruchholtz
Review Article


Balloon kyphoplasty and percutaneous vertebroplasty are relatively recent procedures in the treatment of painful vertebral fractures. There are, however, still some uncertainties about the incidence and treatment strategies of pulmonary cement embolisms (PCE). In order to work out a treatment strategy for the management of this complication, we performed a review of the literature. The results show that there is no clear diagnostic or treatment standard for PCE. The literature research revealed that the risk of a pulmonary embolism ranges from 3.5 to 23% for osteoporotic fractures. In cases of asymptomatic patients with peripheral PCE we recommend no treatment besides clinical follow-up; in cases of symptomatic or central embolisms, however, we recommend to proceed according to the guidelines regarding the treatment of thrombotic pulmonary embolisms, which includes initial heparinization and a following 6-month coumarin therapy. In order to avoid any types of embolisms, both procedures should only be performed by experienced surgeons after critical determination of the indications.


Vertebroplasty Kyphoplasty Complication Cement leakage Pulmonary embolism 


  1. 1.
    Abdul-Jalil Y, Bartels J, Alberti O, Becker R (2007) Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty. Spine 32:E589–E593. doi: 10.1097/BRS.0b013e31814b84ba PubMedCrossRefGoogle Scholar
  2. 2.
    Amar AP, Larsen DW, Esnaashari N, Albuquerque FC, Lavine SD, Teitelbaum GP (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–1114. doi: 10.1097/00006123-200111000-00017 PubMedCrossRefGoogle Scholar
  3. 3.
    Anselmetti GC, Corgnier A, Debernardi F, Regge D (2005) Treatment of painful compression vertebral fractures with vertebroplasty: results and complications. Radiol Med (Torino) 110:262–272Google Scholar
  4. 4.
    Anselmetti GC, Zoarski G, Manca A et al (2008) Percutaneous vertebroplasty and bone cement leakage: clinical experience with a new high-viscosity bone cement and delivery system for vertebral augmentation in benign and malignant compression fractures. Cardiovasc Intervent RadiolGoogle Scholar
  5. 5.
    Barbero S, Casorzo I, Durando M et al (2008) Percutaneous vertebroplasty: the follow-up. Radiol Med (Torino) 113:101–113. doi: 10.1007/s11547-008-0234-0 CrossRefGoogle Scholar
  6. 6.
    Baroud G, Crookshank M, Bohner M (2006) High-viscosity cement significantly enhances uniformity of cement filling in vertebroplasty: an experimental model and study on cement leakage. Spine 31:2562–2568. doi: 10.1097/01.brs.0000240695.58651.62 PubMedCrossRefGoogle Scholar
  7. 7.
    Barragan-Campos HM, Vallee JN, Lo D et al (2006) Percutaneous vertebroplasty for spinal metastases: complications. Radiology 238:354–362. doi: 10.1148/radiol.2381040841 PubMedCrossRefGoogle Scholar
  8. 8.
    Baumann A, Tauss J, Baumann G, Tomka M, Hessinger M, Tiesenhausen K (2005) Cement embolization into the vena cava and pulmonal arteries after vertebroplasty: interdisciplinary management. Eur J Vasc Endovasc Surg 31:558–561PubMedCrossRefGoogle Scholar
  9. 9.
    Bernhard J, Heini PF, Villiger PM (2003) Asymptomatic diffuse pulmonary embolism caused by acrylic cement: an unusual complication of percutaneous vertebroplasty. Ann Rheum Dis 62:85–86. doi: 10.1136/ard.62.1.85 PubMedCrossRefGoogle Scholar
  10. 10.
    Boger A, Heini P, Windolf M, Schneider E (2007) Adjacent vertebral failure after vertebroplasty: a biomechanical study of low-modulus PMMA cement. Eur Spine J 16:2118–2125PubMedCrossRefGoogle Scholar
  11. 11.
    Bohner M, Gasser B, Baroud G, Heini P (2003) Theoretical and experimental model to describe the injection of a polymethylmethacrylate cement into a porous structure. Biomaterials 24:2721–2730. doi: 10.1016/S0142-9612(03)00086-3 PubMedCrossRefGoogle Scholar
  12. 12.
    Bonardel G, Pouit B, Gontier E et al (2007) Pulmonary cement embolism after percutaneous vertebroplasty: a rare and nonthrombotic cause of pulmonary embolism. Clin Nucl Med 32:603–606. doi: 10.1097/RLU.0b013e3180a1ad5a PubMedCrossRefGoogle Scholar
  13. 13.
    Calmels V, Vallee JN, Rose M, Chiras J (2007) Osteoblastic and mixed spinal metastases: evaluation of the analgesic efficacy of percutaneous vertebroplasty. AJNR Am J Neuroradiol 28:570–574PubMedGoogle Scholar
  14. 14.
    Caudana R, Renzi BL, Ventura L, Aitini E, Rozzanigo U, Barai G (2008) CT-guided percutaneous vertebroplasty: personal experience in the treatment of osteoporotic fractures and dorsolumbar metastases. Radiol Med (Torino) 113:114–133. doi: 10.1007/s11547-008-0230-1 CrossRefGoogle Scholar
  15. 15.
    Charvet A, Metellus P, Bruder N, Pellissier D, Grisoli F, Gouin F (2004) Pulmonary embolism of cement during vertebroplasty. Ann Fr Anesth Reanim 23:827–830. doi: 10.1016/j.annfar.2004.06.005 PubMedGoogle Scholar
  16. 16.
    Chen HL, Wong CS, Ho ST, Chang FL, Hsu CH, Wu CT (2002) A lethal pulmonary embolism during percutaneous vertebroplasty. Anesth Analg 95:1060–1062. doi: 10.1097/00000539-200210000-00049 tablePubMedCrossRefGoogle Scholar
  17. 17.
    Chen LH, Niu CC, Yu SW, Fu TS, Lai PL, Chen WJ (2004) Minimally invasive treatment of osteoporotic vertebral compression fracture. Chang Gung Med J 27:261–267PubMedGoogle Scholar
  18. 18.
    Choe DH, Marom EM, Ahrar K, Truong MT, Madewell JE (2004) Pulmonary embolism of polymethyl methacrylate during percutaneous vertebroplasty and kyphoplasty. AJR Am J Roentgenol 183:1097–1102PubMedGoogle Scholar
  19. 19.
    de Falco R, Scarano E, Di Celmo D, Grasso U, Guarnieri L (2005) Balloon kyphoplasty in traumatic fractures of the thoracolumbar junction. Preliminary experience in 12 cases. J Neurosurg Sci 49:147–153PubMedGoogle Scholar
  20. 20.
    Deramond H, Depriester C, Galibert P, Le Gars D (1998) Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am 36:533–546. doi: 10.1016/S0033-8389(05)70042-7 PubMedCrossRefGoogle Scholar
  21. 21.
    Duran C, Sirvanci M, Aydogan M, Ozturk E, Ozturk C, Akman C (2007) Pulmonary cement embolism: a complication of percutaneous vertebroplasty. Acta Radiol 48:854–859PubMedCrossRefGoogle Scholar
  22. 22.
    Francois K, Taeymans Y, Poffyn B, Van Nooten G (2003) Successful management of a large pulmonary cement embolus after percutaneous vertebroplasty: a case report. Spine 28:E424–E425. doi: 10.1097/01.BRS.0000092345.00563.E0 PubMedCrossRefGoogle Scholar
  23. 23.
    Freitag M, Gottschalk A, Schuster M, Wenk W, Wiesner L, Standl TG (2006) Pulmonary embolism caused by polymethylmethacrylate during percutaneous vertebroplasty in orthopaedic surgery. Acta Anaesthesiol Scand 50:248–251. doi: 10.1111/j.1399-6576.2005.00821.x PubMedCrossRefGoogle Scholar
  24. 24.
    Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168PubMedGoogle Scholar
  25. 25.
    Gangi A, Guth S, Imbert JP, Marin H, Dietemann JL (2003) Percutaneous vertebroplasty: indications, technique, and results. Radiographics 23:e10. doi: 10.1148/rg.e10 PubMedCrossRefGoogle Scholar
  26. 26.
    Garfin SR, Yuan HA, Reiley MA (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 26:1511–1515. doi: 10.1097/00007632-200107150-00002 PubMedCrossRefGoogle Scholar
  27. 27.
    Georgy BA (2007) Interventional techniques in managing persistent pain after vertebral augmentation procedures: a retrospective evaluation. Pain Phys 10:673–676Google Scholar
  28. 28.
    Gigante N, Pierangeli E (2008) Minimally invasive anterior approach for kyphoplasty of the first thoracic vertebra in a patient with multiple myeloma. Minim Invasive Neurosurg 51:26–29. doi: 10.1055/s-2007-1004560 PubMedCrossRefGoogle Scholar
  29. 29.
    Grados F, Depriester C, Cayrolle G, Hardy N, Deramond H, Fardellone P (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 39:1410–1414. doi: 10.1093/rheumatology/39.12.1410 CrossRefGoogle Scholar
  30. 30.
    Harris B, Briggs G, Dennis C (2007) Cement pulmonary embolism as a consequence of vertebroplasty. Intern Med J 37:196–197. doi: 10.1111/j.1445-5994.2006.01282.x PubMedCrossRefGoogle Scholar
  31. 31.
    Hauck S, Beisse R, Bühren V (2005) Vertebroplasty and kyphoplasty in spinal trauma. Eur J Trauma 31:453–463. doi: 10.1007/s00068-005-2104-y CrossRefGoogle Scholar
  32. 32.
    Heffernan EJ, O’Sullivan PJ, Alkubaidan FO, Heran MK, Legiehn GM, Munk PL (2008) The current status of percutaneous vertebroplasty in Canada. Can Assoc Radiol J 59:77–82PubMedGoogle Scholar
  33. 33.
    Hierholzer J, Depriester C, Fuchs H et al (2002) Percutaneous vertebroplasty. Rofo 174:328–334PubMedGoogle Scholar
  34. 34.
    Hierholzer J, Fuchs H, Westphalen K, Venz S, Pappert D, Depriester C (2005) Percutaneous vertebroplasty—the role of osseous phlebography. Rofo 177:386–392PubMedGoogle Scholar
  35. 35.
    Hirsh J, Guyatt G, Albers GW, Schünemann HJ (2004) Proceedings of the seventh ACCP conference on antithrombotic and thrombolytic therapy: evidence-based guidelines. Chest 126:172S–696S. doi: 10.1378/chest.126.3_suppl.172S CrossRefGoogle Scholar
  36. 36.
    Hodler J, Peck D, Gilula LA (2003) Midterm outcome after vertebroplasty: predictive value of technical and patient-related factors. Radiology 227:662–668. doi: 10.1148/radiol.2273011930 PubMedCrossRefGoogle Scholar
  37. 37.
    Jang JS, Lee SH (2005) Efficacy of percutaneous vertebroplasty combined with radiotherapy in osteolytic metastatic spinal tumors. J Neurosurg Spine 2:243–248PubMedCrossRefGoogle Scholar
  38. 38.
    Jang JS, Lee SH, Jung SK (2002) Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: a report of three cases. Spine 27:E416–E418. doi: 10.1097/00007632-200210010-00021 PubMedCrossRefGoogle Scholar
  39. 39.
    Kaufmann TJ, Trout AT, Kallmes DF (2006) The effects of cement volume on clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol 27:1933–1937PubMedGoogle Scholar
  40. 40.
    Kelekis AD, Martin JB, Somon T, Wetzel SG, Dietrich PY, Ruefenacht DA (2003) Radicular pain after vertebroplasty: compression or irritation of the nerve root? Initial experience with the “cooling system”. Spine 28:E265–E269. doi: 10.1097/00007632-200307150-00027 PubMedCrossRefGoogle Scholar
  41. 41.
    Kim SY, Seo JB, Do KH, Lee JS, Song KS, Lim TH (2005) Cardiac perforation caused by acrylic cement: a rare complication of percutaneous vertebroplasty. AJR Am J Roentgenol 185:1245–1247. doi: 10.2214/AJR.04.1443 PubMedCrossRefGoogle Scholar
  42. 42.
    Kim YJ, Lee JW, Park KW et al (2009) Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures: incidence, characteristics, and risk factors. Radiology 251:250–259. doi: 10.1148/radiol.2511080854 PubMedCrossRefGoogle Scholar
  43. 43.
    Koch CA, Layton KF, Kallmes DF (2007) Outcomes of patients receiving long-term corticosteroid therapy who undergo percutaneous vertebroplasty. AJNR Am J Neuroradiol 28:563–566. doi: 10.3174/ajnr.A0634 PubMedCrossRefGoogle Scholar
  44. 44.
    Koyama M, Takizawa K, Kobayashi K et al (2005) Initial experience of percutaneous vertebroplasty using single-plane C-arm fluoroscopy for guidance. Radiat Med 23:256–260PubMedGoogle Scholar
  45. 45.
    Laredo JD, Hamze B (2005) Complications of percutaneous vertebroplasty and their prevention. Semin Ultrasound CT MR 26:65–80. doi: 10.1053/j.sult.2005.02.003 PubMedCrossRefGoogle Scholar
  46. 46.
    Layton KF, Thielen KR, Koch CA et al (2007) Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complications. AJNR Am J Neuroradiol 28:683–689PubMedGoogle Scholar
  47. 47.
    Legroux-Gerot I, Lormeau C, Boutry N, Cotten A, Duquesnoy B, Cortet B (2004) Long-term follow-up of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Clin Rheumatol 23:310–317. doi: 10.1007/s10067-004-0914-7 PubMedCrossRefGoogle Scholar
  48. 48.
    Leroux G, Costedoat-Chalumeau N, Chiras J, de Gennes C, Piette JC (2007) A vertebroplasty with dyspnea. Rev Med Interne 28:492–494. doi: 10.1016/j.revmed.2006.11.006 PubMedCrossRefGoogle Scholar
  49. 49.
    Liliang PC, Lu K, Liang CL, Tsai YD, Hsieh CH, Chen HJ (2007) Dyspnoea and chest pain associated with pulmonary polymethylmethacrylate embolism after percutaneous vertebroplasty. Injury 38:245–248. doi: 10.1016/j.injury.2006.08.031 PubMedCrossRefGoogle Scholar
  50. 50.
    Lim KJ, Yoon SZ, Jeon YS et al (2007) An intraatrial thrombus and pulmonary thromboembolism as a late complication of percutaneous vertebroplasty. Anesth Analg 104:924–926. doi: 10.1213/01.ane.0000256974.84535.7a PubMedCrossRefGoogle Scholar
  51. 51.
    Lim SH, Kim H, Kim HK, Baek MJ (2008) Multiple cardiac perforations and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty. Eur J Cardiothorac Surg 33:510–512PubMedCrossRefGoogle Scholar
  52. 52.
    Lin CC, Chen IH, Yu TC, Chen A, Yen PS (2007) New symptomatic compression fracture after percutaneous vertebroplasty at the thoracolumbar junction. AJNR Am J Neuroradiol 28:1042–1045. doi: 10.3174/ajnr.A0520 PubMedCrossRefGoogle Scholar
  53. 53.
    Lin WC, Lee YC, Lee CH et al (2008) Refractures in cemented vertebrae after percutaneous vertebroplasty: a retrospective analysis. Eur Spine J 17:592–599. doi: 10.1007/s00586-007-0564-y PubMedCrossRefGoogle Scholar
  54. 54.
    MacTaggart JN, Pipinos II, Johanning JM, Lynch TG (2006) Acrylic cement pulmonary embolus masquerading as an embolized central venous catheter fragment. J Vasc Surg 43:180–183. doi: 10.1016/j.jvs.2005.09.002 PubMedCrossRefGoogle Scholar
  55. 55.
    Masala S, Mastrangeli R, Petrella MC, Massari F, Ursone A, Simonetti G (2008) Percutaneous vertebroplasty in 1,253 levels: results and long-term effectiveness in a single centre. Eur Radiol 19:165–171PubMedCrossRefGoogle Scholar
  56. 56.
    McDonald RJ, Trout AT, Gray LA, Dispenzieri A, Thielen KR, Kallmes DF (2008) Vertebroplasty in multiple myeloma: outcomes in a large patient series. AJNR Am J Neuroradiol 29:642–648. doi: 10.3174/ajnr.A0918 PubMedCrossRefGoogle Scholar
  57. 57.
    Monticelli F, Meyer HJ, Tutsch-Bauer E (2005) Fatal pulmonary cement embolism following percutaneous vertebroplasty (PVP). Forensic Sci Int 149:35–38. doi: 10.1016/j.forsciint.2004.06.010 PubMedCrossRefGoogle Scholar
  58. 58.
    Moreland DB, Landi MK, Grand W (2001) Vertebroplasty: techniques to avoid complications. Spine J 1:66–71. doi: 10.1016/S1529-9430(01)00013-4 PubMedCrossRefGoogle Scholar
  59. 59.
    Mousavi P, Roth S, Finkelstein J, Cheung G, Whyne C (2003) Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae. J Neurosurg 99:56–59PubMedGoogle Scholar
  60. 60.
    Neuwirth J, Weber JC, Kohler B (2006) Pulmonary cement embolism after vertebroplasty in multiple osteoporotic vertebral fractures. Dtsch Med Wochenschr 131:2275–2276. doi: 10.1055/s-2006-951363 CrossRefGoogle Scholar
  61. 61.
    Noldge G, Da Fonseca K, Grafe I et al (2006) Balloonkyphoplasty in the treatment of back pain. Radiologe 46:506–512PubMedCrossRefGoogle Scholar
  62. 62.
    Nussbaum DA, Gailloud P, Murphy K (2004) A review of complications associated with vertebroplasty and kyphoplasty as reported to the Food and Drug Administration medical device related web site. J Vasc Interv Radiol 15:1185–1192PubMedGoogle Scholar
  63. 63.
    Oner FC, Verlaan JJ, Verbout AJ, Dhert WJ (2006) Cement augmentation techniques in traumatic thoracolumbar spine fractures. Spine 31:S89–S95. doi: 10.1097/01.brs.0000217950.60516.e6 PubMedCrossRefGoogle Scholar
  64. 64.
    Ormsby EL, Dublin AB (2008) Value of the vertebrogram in predicting cement filling patterns with unipedicular percutaneous vertebroplasty. Acta Radiol 49:344–350. doi: 10.1080/02841850701864685 PubMedCrossRefGoogle Scholar
  65. 65.
    Padovani B, Kasriel O, Brunner P, Peretti-Viton P (1999) Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty. AJNR Am J Neuroradiol 20:375–377PubMedGoogle Scholar
  66. 66.
    Perrin C, Jullien V, Padovani B, Blaive B (1999) Percutaneous vertebroplasty complicated by pulmonary embolus of acrylic cement. Rev Mal Respir 16:215–217PubMedGoogle Scholar
  67. 67.
    Pflugmacher R, Schroeder RJ, Klostermann CK (2006) Incidence of adjacent vertebral fractures in patients treated with balloon kyphoplasty: two years’ prospective follow-up. Acta Radiol 47:830–840. doi: 10.1080/02841850600854928 PubMedCrossRefGoogle Scholar
  68. 68.
    Phillips FM, Todd WF, Lieberman I, Campbell-Hupp M (2002) An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine 27:2173–2178. doi: 10.1097/00007632-200210010-00018 PubMedCrossRefGoogle Scholar
  69. 69.
    Pitton MB, Herber S, Bletz C et al (2007) CT-guided vertebroplasty in osteoprotic vertebral fractures: incidence of secondary fractures and impact of intradiscal cement leakages during follow-up. Eur Radiol 18:43–50PubMedCrossRefGoogle Scholar
  70. 70.
    Pitton MB, Herber S, Koch U, Oberholzer K, Drees P, Duber C (2008) CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures. Eur Radiol 18:2568–2578PubMedCrossRefGoogle Scholar
  71. 71.
    Pleser M, Roth R, Worsdorfer O, Manke C (2004) Pulmonary embolism caused by PMMA in percutaneous vertebroplasty. Case report and review of the literature. Unfallchirurg 107:807–811. doi: 10.1007/s00113-004-0763-5 PubMedCrossRefGoogle Scholar
  72. 72.
    Pott L, Wippermann B, Hussein S, Gunther T, Brusch U, Fremerey R (2005) PMMA pulmonary embolism and post interventional associated fractures after percutaneous vertebroplasty. OrthopadeGoogle Scholar
  73. 73.
    Purkayastha S, Gupta AK, Kapilamoorthy TR et al (2005) Percutaneous vertebroplasty in the management of vertebral lesions. Neurol India 53:167–173PubMedGoogle Scholar
  74. 74.
    Quesada N, Mutlu GM (2006) Images in cardiovascular medicine. Pulmonary embolization of acrylic cement during vertebroplasty. Circulation 113:e295–e296. doi: 10.1161/CIRCULATIONAHA.105.557017 PubMedCrossRefGoogle Scholar
  75. 75.
    Ratliff J, Nguyen T, Heiss J (2001) Root and spinal cord compression from methylmethacrylate vertebroplasty. Spine 26:E300–E302. doi: 10.1097/00007632-200107010-00021 PubMedCrossRefGoogle Scholar
  76. 76.
    Righini M, Sekoranja L, Le Gal G, Favre I, Bounameaux H, Janssens JP (2006) Pulmonary cement embolism after vertebroplasty. Thromb Haemost 95:388–389PubMedGoogle Scholar
  77. 77.
    Schmidt R, Cakir B, Mattes T, Wegener M, Puhl W, Richter M (2005) Cement leakage during vertebroplasty: an underestimated problem? Eur Spine J 14:466–473PubMedCrossRefGoogle Scholar
  78. 78.
    Schneider L, Plit M (2007) Pulmonary embolization of acrylic cement during percutaneous vertebroplasty. Intern Med J 37:423–425. doi: 10.1111/j.1445-5994.2007.01377.x PubMedCrossRefGoogle Scholar
  79. 79.
    Schoenes B, Bremerich DH, Risteski PS, Thalhammer A, Meininger D (2007) Cardiac perforation after vertebroplasty. Anaesthesist 57:147–150CrossRefGoogle Scholar
  80. 80.
    Scroop R, Eskridge J, Britz GW (2002) Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: case report. AJNR Am J Neuroradiol 23:868–870PubMedGoogle Scholar
  81. 81.
    Seo JS, Kim YJ, Choi BW, Kim TH, Choe KO (2005) MDCT of pulmonary embolism after percutaneous vertebroplasty. AJR Am J Roentgenol 184:1364–1365PubMedGoogle Scholar
  82. 82.
    Serra L, Kermani FM, Panagiotopoulos K, De RV, Vizioli L (2007) Vertebroplasty in the treatment of osteoporotic vertebral fractures: results and functional outcome in a series of 175 consecutive patients. Minim Invasive Neurosurg 50:12–17. doi: 10.1055/s-2006-947994 PubMedCrossRefGoogle Scholar
  83. 83.
    Son KH, Chung JH, Sun K, Son HS (2008) Cardiac perforation and tricuspid regurgitation as a complication of percutaneous vertebroplasty. Eur J Cardiothorac Surg 33:508–509PubMedCrossRefGoogle Scholar
  84. 84.
    Stoffel M, Wolf I, Ringel F, Stuer C, Urbach H, Meyer B (2007) Treatment of painful osteoporotic compression and burst fractures using kyphoplasty: a prospective observational design. J Neurosurg Spine 6:313–319. doi: 10.3171/spi.2007.6.4.5 PubMedCrossRefGoogle Scholar
  85. 85.
    Stricker K, Orler R, Yen K, Takala J, Luginbuhl M (2004) Severe hypercapnia due to pulmonary embolism of polymethylmethacrylate during vertebroplasty. Anesth Analg 98:1184–1186. doi: 10.1213/01.ANE.0000104585.83801.C5 tablePubMedCrossRefGoogle Scholar
  86. 86.
    Syed MI, Patel NA, Jan S, Harron MS, Morar K, Shaikh A (2005) New symptomatic vertebral compression fractures within a year following vertebroplasty in osteoporotic women. AJNR Am J Neuroradiol 26:1601–1604PubMedGoogle Scholar
  87. 87.
    Tanigawa N, Komemushi A, Kariya S, Kojima H, Shomura Y, Sawada S (2005) Radiological follow-up of new compression fractures following percutaneous vertebroplasty. Cardiovasc Intervent Radiol 29:92–96CrossRefGoogle Scholar
  88. 88.
    Torres Machi ML, Suarez RV, Medina RC, Gil BF, Ojeda BN, Rodriguez-Perez A (2003) Pulmonary embolism caused by cement following vertebroplasty. Rev Esp Anestesiol Reanim 50:489–491PubMedGoogle Scholar
  89. 89.
    Tozzi P, Abdelmoumene Y, Corno AF, Gersbach PA, Hoogewoud HM, von Segesser LK (2002) Management of pulmonary embolism during acrylic vertebroplasty. Ann Thorac Surg 74:1706–1708. doi: 10.1016/S0003-4975(02)03962-0 PubMedCrossRefGoogle Scholar
  90. 90.
    Trout AT, Gray LA, Kallmes DF (2005) Vertebroplasty in the inpatient population. AJNR Am J Neuroradiol 26:1629–1633PubMedGoogle Scholar
  91. 91.
    Venmans A, Lohle PN, van Rooij WJ, Verhaar HJ, Mali WP (2008) Frequency and outcome of pulmonary polymethylmethacrylate embolism during percutaneous vertebroplasty. AJNR Am J Neuroradiol 29:1983–1985. doi: 10.3174/ajnr.A1269 PubMedCrossRefGoogle Scholar
  92. 92.
    Walz M, Esmer E, Kolbow B (2006) CT-based analysis of cement distribution in unipedicular vertebroplasty. Unfallchirurg 109:932–939. doi: 10.1007/s00113-006-1180-8 PubMedCrossRefGoogle Scholar
  93. 93.
    Wong W, Reiley MA, Garfin S (2000) Vertebroplasty/kyphoplasty. J Womens Imaging 2:117–124Google Scholar
  94. 94.
    Wu AS, Fourney DR (2005) Supportive care aspects of vertebroplasty in patients with cancer. Support Cancer Ther 2:98–104. doi: 10.3816/SCT.2005.n.003 PubMedCrossRefGoogle Scholar
  95. 95.
    Yoo KY, Jeong SW, Yoon W, Lee J (2004) Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate. Spine 29:E294–E297. doi: 10.1097/01.BRS.0000131211.87594.B0 PubMedCrossRefGoogle Scholar
  96. 96.
    Zaccheo MV, Rowane JE, Costello EM (2008) Acute respiratory failure associated with polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty. Am J Emerg Med 26:636–637. doi: 10.1016/j.ajem.2007.10.013 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Antonio Krueger
    • 1
    Email author
  • Christopher Bliemel
    • 1
  • Ralph Zettl
    • 1
  • Steffen Ruchholtz
    • 1
  1. 1.Department of Trauma-, Hand- and Reconstructive SurgeryUniversity Hospital Giessen and MarburgMarburgGermany

Personalised recommendations