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Pulmonary cement embolism after pedicle screw vertebral stabilization
Massimo Tonolini1, Roberto Bianco
1Department of Radiology, "Luigi Sacco" University Hospital, Via G. B. Grassi 74, 20157 Milan, Italy.
Journal of Emergencies, Trauma, and Shock
|September 19, 2012
Summary
Pulmonary arterial embolization of polymethylmethacrylate cement is rare after vertebral stabilization. Unenhanced CT scans effectively identify these cement emboli, guiding treatment with anticoagulation.
Area of Science:
- Radiology
- Pulmonary Medicine
- Interventional Procedures
Background:
- Polymethylmethacrylate (PMMA) cement embolization into pulmonary arteries is a rare complication following vertebral stabilization procedures like vertebroplasty and kyphoplasty.
- While uncommon, recognizing this complication is crucial for patient management.
Observation:
- Unenhanced computed tomography (CT) scans at lung window settings are highly effective for identifying PMMA cement emboli within the pulmonary circulation.
- Associated pulmonary parenchymal changes may also be visualized on these scans.
- Hyperdense emboli can be less apparent on CT-angiographic studies utilizing high-flow contrast media.
Findings:
- The clinical presentation of pulmonary cement emboli varies widely, ranging from asymptomatic cases to severe respiratory distress.
- Diagnosis is often confirmed through imaging, with unenhanced CT being a key tool.
Implications:
- Prompt identification of pulmonary cement emboli is essential for appropriate clinical management.
- Anticoagulation is the mainstay treatment for most patients diagnosed with this condition.
- Understanding the diagnostic utility of different CT techniques aids in accurate diagnosis and patient care.
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