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Pulmonary Cement Embolism After Kyphoplasty.
Martina Focardi1, Aurelio Bonelli1, Vilma Pinchi1
1Department of Health Sciences, Forensic Medicine Section, University of Florence, Largo Brambilla 3, Florence, 50134, Italy.
Journal of Forensic Sciences
|November 3, 2015
Summary
Pulmonary embolism from polymethylmethacrylate (PMMA) cement after kyphoplasty (KP) is common. Chemical analysis confirmed PMMA cement as the cause of embolism in a patient, aiding both clinical and forensic investigations.
Area of Science:
- Medical Case Reports
- Forensic Science
- Materials Science
Background:
- Pulmonary embolism is a known complication following kyphoplasty (KP) surgery.
- Embolism can result from polymethylmethacrylate (PMMA) bone cement or central venous catheter fragments.
- Distinguishing the source of embolism is crucial for patient management and legal proceedings.
Observation:
- A patient developed pulmonary embolism post-kyphoplasty and subsequent thoracic surgery.
- The patient filed a claim for damages, citing surgical scar tenderness and aesthetic concerns.
- Chemical investigations, specifically spectrometry, were ordered to identify the embolic material.
Findings:
- Spectrometry analysis definitively identified the embolized material as polymethylmethacrylate (PMMA) cement, consistent with the material used during the kyphoplasty procedure.
- The findings ruled out a central venous catheter fragment as the source of the pulmonary embolism.
Implications:
- Chemical analysis, such as spectrometry, is vital for accurately identifying the origin of embolic material in post-surgical complications.
- These investigations provide critical data for both clinical diagnosis and forensic evaluations when the source of embolism is uncertain.
- This case highlights the importance of precise material identification in managing patient claims and ensuring appropriate medical-legal outcomes.
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