Symptomatic Pulmonary Cement Embolism after Balloon Kyphoplasty and Pedicle Screw Fixation Caused by a Small Peripheral Embolus- A Case Report
Vol 8 | Issue 3 | September-December 2022 | Page: 05-08 | Masami Sato, Munenori Kato, Masahiro Kakuyama
DOI: 10.13107/jaccr.2022.v08i03.206
Author: Masami Sato [1], Munenori Kato [1], Masahiro Kakuyama [1]
[1] Department of Anaesthesia, Kyoto City Hospital, Kyoto, Japan.
Address of Correspondence
Dr. Masami Sato,
Department of Anaesthesia, Kyoto City Hospital, Kyoto, Japan.
E-mail: masami@kb3.so-net.ne.jp
Abstract
Introduction: Pulmonary cement embolism, which is caused by vertebral cement leakage, is a feared but underestimated complication after balloon kyphoplasty. Most pulmonary cement embolism cases are asymptomatic and symptomatic pulmonary cement embolism have been caused by central or peripheral multiple cement emboli.
Case presentation: A 62-year-old man, who underwent three-level thoracolumbar balloon kyphoplasty and pedicle screw fixation for osteoporotic vertebral compression fracture under general anesthesia, experienced hypoxemia postoperatively and dyspnea 1 day after the surgery. Chest computed tomography revealed a small cement embolus in the peripheral pulmonary artery of the right lower lung and confirmed the diagnosis of pulmonary cement embolism. Transthoracic echocardiogram revealed no right heart strain. He was managed successfully under oxygen administration without anticoagulation therapy.
Conclusion: Pulmonary cement embolism after balloon kyphoplasty should be invariably considered as a differential diagnosis when postprocedural dyspnea or hypoxemia occurs. Even a small peripheral cement embolus can induce symptomatic pulmonary cement embolism after balloon kyphoplasty.
Keywords: Pulmonary cement embolism, Balloon kyphoplasty, Pedicle screw fixation, Anticoagulation, General anesthesia.
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How to Cite this Article: Sato M, Kato M, Kakuyama M | Symptomatic Pulmonary Cement Embolism after Balloon Kyphoplasty and Pedicle Screw Fixation Caused by a Small Peripheral Embolus- A Case Report | Journal of Anaesthesia and Critical Care Case Reports | September-December 2022; 8(3): 00-00. |
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Tags: Anticoagulation, Balloon kyphoplasty, general anesthesia, Pedicle screw fixation, Pulmonary cement embolism