RT Journal Article
SR Electronic
T1 Cardiac Cement Embolism After Thoracic Kyphoplasty: Successful Conservative Treatment With 4-Year Follow-Up
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 8173
DO 10.14444/8173
A1 Mills, Sarah
A1 Pizones, Javier
A1 Merino Rueda, Luis Rodrigo
A1 Talavera, Gloria
A1 Sánchez-Márquez, José Miguel
A1 Fernández-Baíllo, Nicomedes
YR 2022
UL https://www.ijssurgery.com/content/early/2022/02/17/8173.abstract
AB Background The present case report describes a complication after a percutaneous spine surgery technique that is highly uncommon in clinical practice: a bone cement cardiac embolism. This rare complication emphasizes the importance of this case, which is also interesting considering the midterm follow-up. Documented cardiac embolisms published in the literature (which are scarce) describe the acute phase of these cases but lack follow-up. There are no systematic reviews on this topic, only case-by-case presentations, and surgeons are not aware of its real implications.Case We report a case of an 84-year-old man who developed sudden thoracic and spinal pain associated with 82% saturation and dyspnea a few hours after 4-level thoracic spine vertebroplasty and kyphoplasty. Imaging revealed multiple bone cement embolisms in his lung and heart. Because the patient was hemodynamically stable, cardiologists recommended conservative treatment with low molecular weight heparin, without embolus removal. At 4-year follow-up, the patient remained asymptomatic.Conclusion Cardiac cement embolization following percutaneous techniques represents a life-threatening situation that should be ruled out if the patient presents symptoms during the early postoperative period. Treatment may vary from conservative to emergency open-heart surgery.