Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: a report of three cases.

STUDY

DESIGN

Three cases of pulmonary embolism caused by polymethylmethacrylate (PMMA) after percutaneous vertebroplasty are reported, and the literature is reviewed.

OBJECTIVES

To report on three cases of pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty, and to review the literature briefly for reduction of this complication.

SUMMARY OF BACKGROUND DATA: Pulmonary embolus caused by polymethylmethacrylate during percutaneous vertebroplasty is a rare complication. However, there is always a potential risk of this complication, which may result in pulmonary infarction.

METHODS

Three of 27 patients with malignant spinal tumor experienced pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty. Cement migration into the venous channel was observed in two patients, but not during the procedure. Two patients had mild dyspnea and chest discomfort, and one was asymptomatic. Pulmonary embolism was confirmed on chest radiographs. Ventilation perfusion scanning was performed to detect perfusion defect in all cases.

RESULTS

Ventilation perfusion scanning showed no perfusion defects in any case. The symptoms of dyspnea and chest discomfort in two patients subsided after treatment using supplemental oxygen inhalation and anticoagulants.

CONCLUSIONS

Three cases of pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty are reported. Proper techniques can minimize the risk of pulmonary embolism caused by poly-methylmethacrylate during percutaneous vertebroplasty.