Pulmonary cement embolism: A complication of percutaneous vertebroplasty

Background: Percutaneous vertebroplasty ( PV) has recently become a very common procedure for vertebral compression fractures. Extravasation of cement, a common event associated with vertebroplasty, may lead to cement emboli in the lungs. Purpose: To determine the frequency of pulmonary cement embolism after percutaneous vertebroplasty. Material and Methods: Between 2002 and 2006, 128 percutaneous vertebroplasties were performed in 73 patients ( 56 women and 17 men) in our institution. Postprocedural chest radiographs were obtained for all patients and assessed for the presence of pulmonary cement emboli. Results: Pulmonary cement embolism was detected on chest radiographs and confirmed with chest computed tomography ( CT) in four patients treated with percutaneous vertebroplasty for osteoporotic collapse and one patient treated for multiple myeloma. The imaging finding of pulmonary cement embolism was solitary or multiple fine radiodense lines with occasional branching patterns. The frequency of pulmonary cement embolism was 6.8%. Conclusion: An incidence of pulmonary cement embolism of 6.8% during PV was found. Close clinical follow-up, postprocedural chest radiographs, and chest CT scans, if necessary, are important for the detection of pulmonary cement embolism at an early stage.