Perforation of the right cardiac ventricular wall by polymethylmethacrylate after lumbar kyphoplasty.

The authors report the case of a 74-year-old woman who underwent an L-2 vertebral kyphoplasty. The patient experienced delayed postoperative hemodynamic deterioration that may have been caused by embolization of polymethylmethacrylate (PMMA) cement through the right cardiac ventricular wall. Cardiac and pulmonary embolization of bone cement can develop as a complication of vertebral kyphoplasty. Surgeons should be alert to this potentially life-threatening condition when performing this increasingly popular form of spine procedure.

[1]  D. Gelb,et al.  41. Neurological Deficit Following Percutaneous Vertebral Stabilization , 2007 .

[2]  R. Taylor,et al.  Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis , 2007, European Spine Journal.

[3]  J. Seo,et al.  Cardiac perforation caused by acrylic cement: a rare complication of percutaneous vertebroplasty. , 2005, AJR. American journal of roentgenology.

[4]  K. Ahrar,et al.  Pulmonary embolism of polymethyl methacrylate during percutaneous vertebroplasty and kyphoplasty. , 2004, AJR. American journal of roentgenology.

[5]  K. Kuizenga,et al.  Anatomical and Pathological Considerations in Percutaneous Vertebroplasty and Kyphoplasty: A Reappraisal of the Vertebral Venous System , 2004, Spine.

[6]  L. Gilula,et al.  Midterm outcome after vertebroplasty: predictive value of technical and patient-related factors. , 2003, Radiology.

[7]  K. Ahrar,et al.  Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. , 2003, Journal of neurosurgery.

[8]  N. Beauchamp,et al.  Is percutaneous vertebroplasty without pretreatment venography safe? Evaluation of 205 consecutives procedures. , 2002, AJNR. American journal of neuroradiology.

[9]  D F Kallmes,et al.  Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. , 1997, AJNR. American journal of neuroradiology.

[10]  R. Assaker,et al.  Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. , 1996, Radiology.

[11]  J. Chiras,et al.  Spinal metastases: indications for and results of percutaneous injection of acrylic surgical cement. , 1996, Radiology.

[12]  H. Vogelsang,et al.  [Transosseous phlebography of the vertebral column and spinal canal. Morphological and clinical aspects]. , 1970, Verhandlungen der Anatomischen Gesellschaft.