CASE REPORT article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1643103
This article is part of the Research TopicClinical and Basic Research on Chronic Spinal Cord Injury Associated with Spinal DegenerationView all 16 articles
Cement leakage into the paravertebral venous system and pulmonary cement embolism following percutaneous vertebroplasty: a case report
Provisionally accepted- 1Binzhou Medical University, Binzhou, China
- 2Liaocheng People's Hospital, Liaocheng, China
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Pulmonary cement embolism is a potentially serious complication following percutaneous vertebroplasty. The risk factors for pulmonary cement embolism have not been clearly identifed. Cement leakage into the azygos vein or in the inferior vena cava has been identifed as a risk factor for pulmonary cement embolism. In addition cement leakage into the paravertebral venous system also seems to be related to pulmonary cement embolism. Here we report a case with detailed preoperative data, intraoperative findings, and imaging evidence to demonstrate the relationship between cement leakage into the paravertebral venous system and pulmonary cement embolism. Case A 69-year-old woman was diagnosed with osteoporotic vertebral compression fractures and treated with percutaneous vertebroplasty. Intraoperatively, anterior cement leakage into the paravertebral venous system was detected on lateral fluoroscopy but it did not cause insufficient attention. The patient demonstrated significant back pain relief postoperatively, and had no symptoms such as dyspnoea, coughing, haemoptysis, dizziness or palpitation. However, the postoperative thoracolumbar X-ray presented that multiple tubular and branching cement emboli were scattered throughout the lungs. The patient presented asymptomatically in the follow-up period . No cardiorespiratory dysfunction was observed until the end of the one-year clinical follow-up, and the patient was satisfied with pain relief. Conclusion Cement leakage into the paravertebral venous system is associated with pulmonary cement embolism during percutaneous vertebroplasty. Continued bone cement injection after bone cement leakage into the paravertebral venous system is dangerous and, may lead to further migration and, ultimately, pulmonary cement embolism. Once bone cement leakage into the parav ertebral venous system is detected, percutaneous vertebroplasty should be terminated.
Keywords: Percutaneous vertebroplasty, Pulmonary cement embolism, Bone cement leakage, Paravertebral venous plexus, case report
Received: 08 Jun 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Lai, Qingcun Meng, Zhang, Liu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yanbin Liu, yb198080@163.com
Jinlong Liu, drjinlongliu@163.com
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