Pulmonary Embolism Caused by Acrylic Cement: Report of Two Cases Developed as a Complication of Percutaneous Vertebroplasty

Percutaneous vertebroplasty is an effective, minimally invasive procedure for the treatment of vertebral compression fractures, and is a technique for treating lower back pain that appears to be increasingly popular throughout the world. We experienced two cases involving a rare complication of percutaneous vertebroplasty, namely pulmonary embolism caused by acrylic cement. One patient showed no subjective symptoms after vertebroplasty, while the other experienced chest pain. In the former, fluoroscopy demonstrated perivertebral venous leakage during vertebroplasty, and at chest radiography, tubular or branching high-density linear structures were observed. In addition, intravascular emboli were identified at CT. In the second patient, symptomatic therapy led to reduced chest pain.

Percutaneous Vertebroplasty for the Treatment of Osteoporotic Vertebral Compression Fractures

PURPOSE: To assess the usefulness of percutaneous vertebroplasty for the treatment of painful osteoporotic vertebral compression fractures. MATERIALS AND METHODS: Eighty five patients [70 women and 15 men aged 51-88 (mean, 70) years with 148 vertebral compression fractures underwent percutaneous vertebroplasty. The causes of fracture were slip, lifting, fall, traffic accident, walking, and other unknown causes; the duration of pain varied from three days to two years. All patients underwent MRI or CT to assess the recent condition of the fracture, and vertebroplasty was performed under DSA fluoroscopic guidance. Routine clinical follow-up examination involved visual analogue pain-scale testing one and two days after vertebroplasty; the results obtained were compared with those of preoperative assessment. The outcome of vertebroplasty was assessed in terms of its efficacy and resulting complications, if any. RESULTS: The procedures were technically successful in all patients. In 73, back pain was relieved within 24 hours; in nine, within 48 hours and in one, within seven days. In two patients, pain relief was insignificant, and one of these died. CONCLUSION: Percutaneous vertebroplasty was a useful procedure for treating painful osteoporotic compression fractures.