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Renal cement embolism during percutaneous vertebroplasty

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Abstract

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.

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References

  1. 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 49:1105–1115

    Article  PubMed  CAS  Google Scholar 

  2. Barr JD, Barr MS, Lemley TJ, McCann RM (2000) Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 25:923–928

    Article  PubMed  CAS  Google Scholar 

  3. Barr MA, Barr JD (1998) Invited commentary. RadioGraphics 18:320–322

    Google Scholar 

  4. 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

    Article  PubMed  CAS  Google Scholar 

  5. Cotten A, Dewarte F, Coret B, Assaker R, Leblond D, Duquesnoy B, Chastanet P, Clarisse J (1996) Percutaneous vertebroplasty for osteolytic metastases and myeloma; effects of the percentage of lesion filling and the leakage of methylmethacrylate at clinical follow-up. Radiology 200:525–530

    PubMed  CAS  Google Scholar 

  6. Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramon H (1998) Percutaneous vertebroplasty: state of the art. Radiographics 18:311–320

    PubMed  CAS  Google Scholar 

  7. Deramond H, Galibert P, Debussche C (1990) Percutaneous vertebroplasty with methylmethacrylate: technique, method, result. Radiology 177:352

    Google Scholar 

  8. Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. AJNR Am J Neuroradiol 15:83–86

    PubMed  CAS  Google Scholar 

  9. Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168

    PubMed  CAS  Google Scholar 

  10. Groen RJ, du Toit DF, Phillips FM, Hoogland PV, Kuizenga K, Coppes MH, Muller CJ, Grobbelaar M, Mattyssen J (2004) Anatomical and pathological considerations in percutaneous vertebroplasty and kyphoplasty: a reappraisal of the vertebral venous system. Spine 29:1465–1471

    Article  PubMed  Google Scholar 

  11. Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion HE (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 18:1897–1904

    PubMed  CAS  Google Scholar 

  12. Lane JM, Johnson CE, Khan SN, Girardi FP, Cammisa FP Jr (2002) Minimally invasive options for the treatment of osteoporotic vertebral compression fractures. Orthop Clin North Am 33:431–438

    Article  PubMed  Google Scholar 

  13. Martin JB, Jean B, Sugiu K, San Millan Ruiz D, Piotin M, Murphy K, Rufenacht B, Muster M, Rufenacht DA (1999) Vertebroplasty: clinical experience and follow-up results. Bone 25:11S–15S

    Article  PubMed  CAS  Google Scholar 

  14. Padovani B, Kasriel O, Brunner P, Perretti-Viton P (1999) Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty.AJNR Am J Neuroradiol 20:375–377

    PubMed  CAS  Google Scholar 

  15. Scroop R, Eskridge J, Brz GW (2002) Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: a case report. Am J Neuroradiol 23:868–870

    PubMed  Google Scholar 

  16. Shapiro S, Abel T, Purvines S (2003) Surgical removal or epidural and intradural polymethymethacrylate extravasation complicating percutaneous vertebroplasty for an osteoporotic lumbar compression fracture. Case report. J Neurosurg 98:90–92

    PubMed  Google Scholar 

  17. Vogelsang H (1970) Intraosseous spinal venography. Excerpta Medica, Amsterdam

    Google Scholar 

  18. Watts NB, Harriw ST, Genant HK (2001) Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty. Osteoporos Int 12:429–437

    Article  PubMed  CAS  Google Scholar 

  19. Weill A, Chiras J, Simon JM, Rola-Martinez T, Enkaoua E (1996) Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. Radiology 199:241–247

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Wooridul Spine Hospital, Seoul, Republic of Korea

    Seung-Eun Chung, Tae-Hong Kim, Kwang Hyun Yoo & Byung-June Jo

  2. Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Republic of Korea

    Sang-Ho Lee

  3. Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea

    Tae-Hong Kim

  4. Department of Orthopedics, Wooridul Spine Hospital, Seoul, Republic of Korea

    Kwang Hyun Yoo

Authors
  1. Seung-Eun Chung
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  2. Sang-Ho Lee
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  3. Tae-Hong Kim
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  4. Kwang Hyun Yoo
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  5. Byung-June Jo
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Correspondence to Seung-Eun Chung.

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Chung, SE., Lee, SH., Kim, TH. et al. Renal cement embolism during percutaneous vertebroplasty. Eur Spine J 15 (Suppl 5), 590–594 (2006). https://doi.org/10.1007/s00586-005-0037-0

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  • DOI: https://doi.org/10.1007/s00586-005-0037-0

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