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Nine-Grid Area Division Method: A New Ideal Bone Puncture Region for Percutaneous Vertebroplasty in Lumbar Spine
09:29

Nine-Grid Area Division Method: A New Ideal Bone Puncture Region for Percutaneous Vertebroplasty in Lumbar Spine

Published on: August 9, 2024

Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty

Youssef Abdul-Jalil1, Joerg Bartels, Olaf Alberti

  • 1Department of Neurosurgery, Asklepios Klinik Schildautal Seesen, Germany. abdul-jalil@gmx.de

Spine
|September 18, 2007
PubMed
Abstract

Insights

Pulmonary embolism of polymethylmethacrylate (PMMA) material can occur after percutaneous vertebroplasty, sometimes with delayed symptoms. Early detection via chest radiography may prevent serious cardiopulmonary complications.

Area of Science:

  • Interventional Radiology
  • Pulmonary Medicine
  • Neurosurgery

Background:

  • Percutaneous vertebroplasty is a common procedure for vertebral fractures with generally good outcomes.
  • Serious complications, though rare, can arise, including pulmonary embolism of polymethylmethacrylate (PMMA).
  • This study reviews the literature and presents two new cases of PMMA pulmonary embolism.

Observation:

  • One patient presented with delayed pulmonary embolism symptoms three days post-procedure, successfully treated with heparin.
  • The second case involved asymptomatic PMMA pulmonary embolism detected one year later, with no intraoperative or perioperative cement leakage identified.
  • These cases highlight the potential for delayed and asymptomatic presentations of PMMA pulmonary embolism.

Findings:

  • The risk of pulmonary embolism of PMMA material following percutaneous vertebroplasty may be underestimated.
  • Clinical manifestations can be delayed, presenting days to over a year after the procedure.
  • Pulmonary PMMA embolism can occur even without detectable cement leakage during or immediately after vertebroplasty.

Implications:

  • Clinicians should be aware of the possibility of delayed pulmonary embolism of PMMA material after percutaneous vertebroplasty.
  • Routine chest radiography following vertebroplasty is proposed to aid in early detection of pulmonary PMMA embolism.
  • Prompt diagnosis and management are crucial to prevent severe delayed cardiopulmonary complications.

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