Abstract
BackgroundVertebroplasty is a minimally invasive procedure commonly performed for vertebral compression fractures secondary to osteoporosis or malignancy. Leakage of bone cement into the paravertebral venous system and cement pulmonary embolism (cPE) are well described, mostly in patients with osteoporosis. Little is known about the clinical sequelae and outcomes in cancer patients. In this study, we report our experience with cPE following vertebroplasty performed in cancer patients.MethodsRecords of all consecutive cancer patients who underwent vertebroplasty at our institution were retrospectively reviewed. The procedure was performed via percutaneous injection of barium-opacified polymethyl-methacrylate cement.ResultsA total of 102 cancer patients with a median age of 53 (19–83) years were included. Seventy-eight (76.5%) patients had malignant vertebral fractures, and 24 (23.5%) patients had osteoporotic fractures. Cement PE was detected in 13 (12.7%) patients; 10 (76.9%) patients had malignant fractures, and the remaining three had osteoporotic fractures. Cement PE was mostly asymptomatic; however, 5 (38.5%) patients had respiratory symptoms that led to the diagnosis. Only the five symptomatic patients were anticoagulated.Cement PE was more common with multiple myeloma (MM); it occurred in 7 (18.9%) of the 37 patients with MM compared with only three (7.3%) of the 41 patients with other malignancies. No difference in incidence was observed between patients with osteoporotic or malignant vertebral fractures.ConclusionsCement PE is a relatively common complication following vertebroplasty and is mostly asymptomatic. Multiple myeloma is associated with the highest risk. Large-scale prospective studies can help identify risk factors and clinical outcomes and could lead to better prevention and therapeutic strategies.
Highlights
Vertebroplasty is a minimally invasive procedure that is commonly performed for vertebral compression fractures secondary to both osteoporosis and malignancy [6]
We report our experience with vertebroplasty performed for vertebral fractures in cancer patients
All imaging studies including computed tomography (CT) scans or plain chest radiographs that were performed following vertebroplasty for any indication were reviewed again by an experienced radiologist to assess for features of cement pulmonary embolism (cPE)
Summary
Vertebroplasty is a minimally invasive procedure commonly performed for vertebral compression fractures secondary to osteoporosis or malignancy. Vertebroplasty is a minimally invasive procedure that is commonly performed for vertebral compression fractures secondary to both osteoporosis and malignancy [6]. Vertebroplasty was first introduced at the University Hospital of Amiens, France, in 1984, when it was used to augment the post-resection defect of a benign spinal tumor [9]. Since it has become an Mansour et al Cancer Imaging (2018) 18:5
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