Case Report: Shock After Percutaneous Vertebroplasty of the 5th Thoracic Vertebra

Overview

Journal Front Surg

Specialty General Surgery

Date 2023 Jun 16

PMID 37325421

Authors

Shenshen Hao

Xin Yu

Laihao Li

Shuai Liu

Hongke Li

Shengli Dong

Xinhao Cao

Affiliations

Soon will be listed here.

Abstract

Background: Percutaneous vertebroplasty (PVP) is a common treatment for osteoporotic vertebral compression fracture (OVCF). Perioperative bleeding is usually rare, so there are few reports of shock. However, we developed shock after treating a case of OVCF of the 5th thoracic vertebra with PVP.

Case Presentation: An 80 years old female patient received PVP due to OVCF of the 5th thoracic vertebra. The operation was successfully completed and the patient returned to the ward safely after the operation. At 90 min after operation, she developed shock, which was induced by subcutaneous hemorrhage up to 1500 ml at the puncture site. Before using vascular embolization, transfusion and blood transfusion were used to maintain blood pressure, and local ice bag compression was used to reduce swelling and stop bleeding, which achieved successful hemostasis. She recovered and discharged after 15 days, with the hematoma having absorbed. There was no recurrence during the 17-month follow-up.

Conclusion: Although PVP is considered to be a safe and effective method to treat OVCF, the possible hemorrhagic shock still needs to arouse the vigilance of surgeons.

Citing Articles

Percutaneous vertebroplasty by two-step fluoroscopy: a treatment for osteoporotic compression fractures of thoracic vertebrae in older adults.

Ge J, Chen K, Xu P, Zhang Z, Wang K, Zhang T BMC Musculoskelet Disord. 2025; 26(1):135.

PMID: 39930416 PMC: 11809072. DOI: 10.1186/s12891-025-08403-7.

References

Laredo J, Hamze B . Complications of percutaneous vertebroplasty and their prevention. Skeletal Radiol. 2004; 33(9):493-505. DOI: 10.1007/s00256-004-0776-8. View

Filippiadis D, Marcia S, Masala S, Deschamps F, Kelekis A . Percutaneous Vertebroplasty and Kyphoplasty: Current Status, New Developments and Old Controversies. Cardiovasc Intervent Radiol. 2017; 40(12):1815-1823. DOI: 10.1007/s00270-017-1779-x. View

Yimin Y, Zhiwei R, Wei M, Jha R . Current status of percutaneous vertebroplasty and percutaneous kyphoplasty--a review. Med Sci Monit. 2013; 19:826-36. PMC: 3795017. DOI: 10.12659/MSM.889479. View

Jay B, Ahn S . Vertebroplasty. Semin Intervent Radiol. 2014; 30(3):297-306. PMC: 3773069. DOI: 10.1055/s-0033-1353483. View

Rapan S, Batrnek J, Rapan V, Biuk E, Rapan D . Quality of Life in Patients Following Vertebroplasty. Open Access Maced J Med Sci. 2017; 5(1):42-47. PMC: 5320906. DOI: 10.3889/oamjms.2017.018. View

Buchbinder R, Johnston R, Rischin K, Homik J, Jones C, Golmohammadi K . Percutaneous vertebroplasty for osteoporotic vertebral compression fracture. Cochrane Database Syst Rev. 2018; 4:CD006349. PMC: 6494647. DOI: 10.1002/14651858.CD006349.pub3. View

Chen L, Lai P, Chen W . Current status of vertebroplasty for osteoporotic compression fracture. Chang Gung Med J. 2011; 34(4):352-9. View

Nezami N, Jarmakani H, Latich I, Groenwald M, Perez Lozada J . Vertebroplasty-associated cement leak leading to iatrogenic venous compression and thrombosis. J Vasc Surg Cases Innov Tech. 2019; 5(4):561-565. PMC: 6911956. DOI: 10.1016/j.jvscit.2019.08.009. View

Zhang J, Poffyn B, Sys G, Uyttendaele D . Comparison of vertebroplasty and kyphoplasty for complications. Orthop Surg. 2011; 3(3):158-60. PMC: 6583283. DOI: 10.1111/j.1757-7861.2011.00141.x. View

10.

Hsieh M, Kao F, Chiu P, Chen L, Yu C, Niu C . Risk factors of neurological deficit and pulmonary cement embolism after percutaneous vertebroplasty. J Orthop Surg Res. 2019; 14(1):406. PMC: 6884871. DOI: 10.1186/s13018-019-1459-4. View

11.

Heo D, Cho Y . Segmental artery injury following percutaneous vertebroplasty using extrapedicular approach. J Korean Neurosurg Soc. 2011; 49(2):131-3. PMC: 3079101. DOI: 10.3340/jkns.2011.49.2.131. View

12.

Kim D, Kim S, Kim H . Cement Emboli Presenting as Right Atrial Mass Caused by Percutaneous Vertebroplasty. Acta Cardiol Sin. 2020; 36(4):390-393. PMC: 7355108. DOI: 10.6515/ACS.202007_36(4).20200213B. View

13.

Biafora S, Mardjetko S, Butler J, McCarthy P, Gleason T . Arterial injury following percutaneous vertebral augmentation: a case report. Spine (Phila Pa 1976). 2006; 31(3):E84-7. DOI: 10.1097/01.brs.0000197596.88416.02. View

14.

Saracen A, Kotwica Z . Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients. Medicine (Baltimore). 2016; 95(24):e3850. PMC: 4998452. DOI: 10.1097/MD.0000000000003850. View

15.

Zhang H, Xuan J, Chen T, Chen Z, Sun L, Tian N . Projection of the Most Anterior Line of the Spinal Canal on Lateral Radiograph: An Anatomic Study for Percutaneous Kyphoplasty and Percutaneous Vertebroplasty. J Invest Surg. 2018; 33(2):134-140. DOI: 10.1080/08941939.2018.1480676. View

16.

Ignacio J, Ignacio K . Pulmonary Embolism from Cement Augmentation of the Vertebral Body. Asian Spine J. 2018; 12(2):380-387. PMC: 5913032. DOI: 10.4184/asj.2018.12.2.380. View

17.

Xie L, Chen X, Yang C, Yan Z, Zhu J, Quan K . Efficacy and complications of I seeds combined with percutaneous vertebroplasty for metastatic spinal tumors: A literature review. Asian J Surg. 2019; 43(1):29-35. DOI: 10.1016/j.asjsur.2019.05.012. View

18.

Cianciulli T, Mc Loughlin D, Morita L, Saccheri M, Lax J . Bone cement cardiac and pulmonary embolism. Echocardiography. 2017; 34(8):1239-1241. DOI: 10.1111/echo.13580. View

19.

Zohra A, Gonlugur U . Cement Pulmonary Embolism Due to Percutaneous Vertebroplasty. Curr Med Imaging. 2020; 17(4):559-561. DOI: 10.2174/1573405616666200923161922. View

20.

Al-Nakshabandi N . Percutaneous vertebroplasty complications. Ann Saudi Med. 2011; 31(3):294-7. PMC: 3119972. DOI: 10.4103/0256-4947.81542. View