Document Detail


Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature.
MedLine Citation:
PMID:  19575243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Balloon kyphoplasty and percutaneous vertebroplasty are relatively recent procedures in the treatment of painful vertebral fractures. There are, however, still some uncertainties about the incidence and treatment strategies of pulmonary cement embolisms (PCE). In order to work out a treatment strategy for the management of this complication, we performed a review of the literature. The results show that there is no clear diagnostic or treatment standard for PCE. The literature research revealed that the risk of a pulmonary embolism ranges from 3.5 to 23% for osteoporotic fractures. In cases of asymptomatic patients with peripheral PCE we recommend no treatment besides clinical follow-up; in cases of symptomatic or central embolisms, however, we recommend to proceed according to the guidelines regarding the treatment of thrombotic pulmonary embolisms, which includes initial heparinization and a following 6-month coumarin therapy. In order to avoid any types of embolisms, both procedures should only be performed by experienced surgeons after critical determination of the indications.
Authors:
Antonio Krueger; Christopher Bliemel; Ralph Zettl; Steffen Ruchholtz
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-07-04
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  18     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-28     Completed Date:  2009-12-15     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1257-65     Citation Subset:  IM    
Affiliation:
Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Giessen and Marburg, Baldingerstrasse, 35043, Marburg, Germany. akrueger@med.uni-marburg.de
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / therapeutic use
Bone Cements / adverse effects*
Humans
Osteoporosis / complications
Patient Selection
Postoperative Complications / chemically induced,  physiopathology,  therapy
Pulmonary Embolism / chemically induced*,  drug therapy*,  physiopathology
Spinal Curvatures / etiology,  prevention & control,  surgery*
Spinal Fractures / complications,  surgery*
Vertebroplasty / adverse effects*,  methods
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Bone Cements
Comments/Corrections

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