Open cavotomy for retrieval of inferior vena cava cement embolism after cement-augmented spinal fusion

Cement leakage during cement-augmented spinal procedures is common, but venous cement embolism remains an uncommon and potentially serious complication. We report the case of an 82-year-old woman who developed a large cement embolus partially occluding the inferior vena cava after cement-augmented spinal surgery. Postoperative imaging demonstrated a mobile intraluminal fragment at the level of the left renal vein, with additional smaller asymptomatic emboli. Given the size and mobility of the embolus, open surgical retrieval through cavotomy was performed with successful en bloc removal. This case highlights that open cavotomy is a safe option for selected patients with high-risk venous cement emboli.