Intracardiac,pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation:A case report and review of literature  

作　　者：Tong-Zhou Liang Hai-Peng Zhu Bo Gao Yan Peng Wen-Jie Gao 

机构地区：[1]Department of Orthopedics,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510289,Guangdong Province,China [2]Department of Orthopedics,Guangdong Women and Children Hospital,Guangzhou 511400,Guangdong Province,China

出　　处：《World Journal of Clinical Cases》2021年第13期3120-3129,共10页世界临床病例杂志

基　　金：Fundamental Research Funds for the Central Universities,No.20ykpy94.

摘　　要：BACKGROUND We report a case of Intracardiac,pulmonary,and intravenous cement embolism after cement-augmented pedicle screw instrumentation in treating spondylolisthesis underlying osteoporotic bone,which was successfully managed by conservative treatment.We describe the treatment and outcome of the patient,hoping to shed light on the management of bone cement embolism.CASE SUMMARY A 67-year-old female suffered from progressive low back pain and numbness in lower extremities for 30 years.She was diagnosed with L4 and L5 spondylolisthesis,spinal stenosis,and osteoporosis.The patient underwent spinal canal decompression,an interbody fusion of L4/5 and L5/S1,cement-augmented pedicle screw instrumentation in L4-L5 segments,and regular pedicle screw in S1 segments.Three days postoperatively,a sudden drop in oxygen saturation occurred.Computerized tomography scan confirmed Intracardiac,pulmonary,and intravenous embolism.The patient was treated conservatively by continuous low-flow oxygen inhalation,anti-coagulation,and antibiotic therapy for 1 mo and continued anticoagulation treatment for 6 mo.The patient showed no further symptoms in a 30-mo follow-up.CONCLUSION Intracardiac,pulmonary cement embolism after cement-augmented pedicle screw instrumentation is extremely rare.Careful clinical and radiographic evaluation is required in multiple sites of bone cement embolism.Conservative treatment may be a primary consideration in scattered emboli without life-threatening conditions,but a clinical decision should be made on an individualized basis.

关 键 词：OSTEOPOROSIS Polymethyl methacrylate cement Pulmonary embolism Cement-augmented pedicle screw instrumentation Conservative treatment Case report 

分 类 号：R687.3[医药卫生—骨科学]