Cement leak at percutaneous vertebroplasty can occur into the foraminal or epidural spaces, with neurological compromise dependent on the volume of leak. Extravasation into the paravertebral veins is a potentially serious complication as it is a direct route to the right side of the heart and therefore for pulmonary embolism. Cement pulmonary emboli may be detected on post-procedure chest x-rays or CT, and may be asymptomatic if small. Reports of cerebral embolism and cardiac perforation have been published. In this case, there was no cement detected elsewhere in the body.