Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Anesthesiol. Sep 27, 2020; 9(1): 7-11
Published online Sep 27, 2020. doi: 10.5313/wja.v9.i1.7
Cement-related embolism after lumbar vertebroplasty: A case report
Zhen-Zhen Xu, Huai-Jin Li, Xue Li, Hong Zhang
Zhen-Zhen Xu, Huai-Jin Li, Xue Li, Hong Zhang, Department of Anesthesiology and Critical Medicine, Peking University First Hospital, Beijing 100034, China
Author contributions: Xu ZZ was responsible for obtaining the patient’s informed consent, collecting patient data, and preparing the manuscript; Li HJ participated in the anesthesia management and revised the manuscript; Li X performed the follow-up for the patient and recorded the in-hospital and out-hospital treatment; Zhang H supervised the anesthesia management and was responsible for revision of the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient’s spouse for publication of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hong Zhang, MD, Associate Professor, Doctor, Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8 Xishiku Street, Beijing 100034, China. zhanghong40@hotmail.com
Received: April 29, 2020
Peer-review started: April 29, 2020
First decision: July 5, 2020
Revised: July 12, 2020
Accepted: August 16, 2020
Article in press: August 16, 2020
Published online: September 27, 2020
Abstract
BACKGROUND

Cement-related embolism is a rare but potentially fatal complication in spinal surgery. Cardiac echocardiography can provide valuable information for the early identification.

CASE SUMMARY

A 66-year-old woman who underwent lumbar vertebroplasty and internal fixation under general anesthesia experienced an episode of supraventricular tachycardia and ventricular tachycardia at the end of surgery. Point-of-care echocardiogram revealed a foreign body in the right heart. After conservative treatment in the intensive care unit, her family decided on comfort care and she expired.

CONCLUSION

Transthoracic echocardiography may provide early valuable information in patients undergoing vertebroplasty, and mild-moderate pericardial effusion may be a significant sign of a poor outcome.

Keywords: Cement embolism, Vertebroplasty, Transthoracic echocardiography, Pericardial effusion, Perioperative management, Cardiovascular event, Case report

Core Tip: With an aging population and increasing tumor occurrence, there is an ever-growing demand for vertebroplasty surgery. Cement related embolism subsequently increases. We recommend echocardiography in the early identification of cement embolism and foreign body with pericardial perfusion should be paid more attention.