What are some complications of vertebroplasty with PMMA (polymethyl methacrylate) cement?
(1) Cement pulmonary embolism (5-25%). (2) Cardiac perforation requiring surgery. (3) Spinal cord involvement from epidural veins, spinal cord involvement, disc involvement requiring spinal surgery.
If you suspect cement embolism what is the next best study?
Non-contrast CT chest through the area of vertebroplasty.
Two high density structures in the right upper lobe are likely cement, based on the cement in the paravertebral veins also. Cement leak into the paravertebral veins can lead to pulmonary cement embolism.
Axial MIP: cement in the lumbar veins