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KMID : 1141120200060010022
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The Nerve
2020 Volume.6 No. 1 p.22 ~ p.26
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Asymptomatic Pulmonary Cement Embolism after Cement-Augmented Pedicle Screw Instrumentation: A Case Report
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Kim Hyun-Jun
Chung Seok-Won
Lee Sang-Ho
Park Chan-Hong
Shin Yong-Hwan
Lee Shin-Young
Kang Min-Soo
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Abstract
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Cement-augmented pedicle screw instrumentation (CAPSI) is a widely used surgical technique in osteoporotic patients. Since CAPSI improves the pull-out strength of screws and enhances bone density of the screwed vertebral body, it can prevent fixation related complications such as screw loosening, and cage subsidence can be prevented. However, several complications due to cement leakage have been reported. Herein we describe a rare case of asymptomatic pulmonary cement embolism (PCE) after CAPSI. A 65-year-old osteoporotic patient was diagnosed with Kummell’s disease at T10. Vertebroplasty at T10 and cement augmented posterior fixation with posterolateral fusion were performed at 2 levels above and below. Postoperatively mild fever, and sputum formation were observed. On a simple chest tomographic image, diffuse PCE was visible on both lung parenchyma. Since his symptoms were not related to PCE no anticoagulant was added to his medication and he was managed conservatively. After conservative care, he was discharged without pulmonary symptom. PCE after CAPSI has been reported in several articles and it can end in the death of the patient. When asymptomatic PCE is detected, close observation with conservative care is a feasible therapeutic strategy.
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KEYWORD
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Bone cements, Pedicle screws, Pulmonary embolism
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