Renal cement embolism during percutaneous vertebroplasty

Eur Spine J. 2006 Oct;15 Suppl 5(Suppl 5):590-4. doi: 10.1007/s00586-005-0037-0. Epub 2005 Dec 14.

Abstract

Percutaneous vertebroplasty (PVP) is an effective treatment for lesions of the vertebral body that involves a percutaneous injection of polymethylmethacrylate (PMMA). Although PVP is considered to be minimally invasive, complications can occur during the procedure. We encountered a renal embolism of PMMA in a 57-year-old man that occurred during PVP. This rare case of PMMA leakage occurred outside of the anterior cortical fracture site of the L1 vertebral body, and multiple tubular bone cements migrated to the course of the renal vessels via the valveless collateral venous network surrounding the L1 body. Although the authors could not explain the exact cause of the renal cement embolism, we believe that physicians should be aware of the fracture pattern, anatomy of the vertebral venous system, and careful fluoroscopic monitoring to minimize the risks during the PVP.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Bone Cements / adverse effects*
  • Bone Cements / therapeutic use
  • Embolism / diagnosis
  • Embolism / etiology*
  • Foreign-Body Migration / complications*
  • Foreign-Body Migration / etiology
  • Fractures, Bone / diagnosis
  • Fractures, Bone / therapy
  • Humans
  • Kidney Diseases / diagnosis
  • Kidney Diseases / etiology*
  • Lumbar Vertebrae / injuries
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Polymethyl Methacrylate / adverse effects*
  • Polymethyl Methacrylate / therapeutic use
  • Tomography, X-Ray Computed
  • Ultrasonography
  • Vertebroplasty / adverse effects*

Substances

  • Bone Cements
  • Polymethyl Methacrylate