Pulmonary embolism caused by PMMA in percutaneous vertebroplasty. Case report and review of the literature

We report on an 80-year-old female patient with osteoporotic collapse of the L1 vertebra who developed absolute stenosis of the spinal canal. During preoperative vertebra augmentation with PMMA (polymethylmethacrylate), pulmonary embolism developed due to perivertebral leakage of acrylic cement. According to the literature, leakage of PMMA during (percutaneous) vertebroplasty is a more frequent complication than assumed so far. In view of the favorable prognosis of osteoporotic vertebral compression fractures with noninvasive management, we emphasize the need for clear and individual indications and adequate technical settings.