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Renal cement embolism during percutaneous vertebroplasty
Seung-Eun Chung1, Sang-Ho Lee, Tae-Hong Kim
1Department of Diagnostic Radiology, Wooridul Spine Hospital, Seoul, Republic of Korea. eunrad@dreamwiz.com
Summary
A rare case of renal embolism occurred during percutaneous vertebroplasty (PVP) when polymethylmethacrylate (PMMA) bone cement migrated through the vertebral venous system. Careful monitoring and awareness of anatomy are crucial to prevent this complication during PVP procedures.
Area of Science:
- Interventional Radiology
- Nephrology
- Orthopedic Surgery
Background:
- Percutaneous vertebroplasty (PVP) is a minimally invasive procedure for vertebral body lesions using polymethylmethacrylate (PMMA).
- While generally safe, PVP carries risks of complications, including cement leakage and embolism.
Observation:
- A 57-year-old male patient undergoing PVP experienced an unusual complication.
- Polymethylmethacrylate (PMMA) bone cement embolized to the renal vasculature.
- The PMMA leakage occurred outside the fracture site of the L1 vertebral body.
Findings:
- Multiple tubular bone cements migrated via the valveless collateral venous network surrounding the L1 vertebral body.
- The exact cause of the renal cement embolism remains undetermined.
- This represents a rare instance of PMMA renal embolism post-PVP.
Implications:
- Highlights the potential for rare but serious complications during PVP.
- Emphasizes the importance of understanding vertebral venous anatomy and fracture patterns.
- Underscores the need for meticulous fluoroscopic monitoring during PVP to mitigate risks.