Open AccessCardiac Perforation Caused by Bone Cements as a Complication of Cement Augmented Pedicle Screw Fixation Using the Fenestrated Pedicle Screw: A Case Report
Author(s) -
Seong Wook Hong,
Tak-Hyuk Oh,
Jae Min Jeon,
YoungSeok Lee,
KyoungTae Kim
Publication year - 2020
Publication title -
korean journal of neurotrauma
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 3
eISSN - 2288-2243
pISSN - 2234-8999
DOI - 10.13004/kjnt.2020.16.e33
Subject(s) - medicine , surgery , bone cement , perforation , spondylolisthesis , percutaneous , fixation (population genetics) , lumbar , cement , population , materials science , environmental health , archaeology , metallurgy , punching , history
Cement-augmented fenestrated pedicle screw fixation is becoming more popular for osteoporotic patients. Although several reports have been published on leakage-related problems with bone cement, no cases of cardiac perforation after cement-augmented pedicle screw fixation have been reported. We present a case of cardiac perforation after cement-augmented fenestrated pedicle screw fixation. A 67-year-old female was admitted to our hospital with complaints of dyspnea and chest pain after lumbar surgery. She had been treated with L4-5 lumbar interbody fusion and percutaneous pedicle screw fixation with bone cement augmentation seven days earlier for degenerative spondylolisthesis. The right chest pain was observed a day after the surgery; she was treated conservatively but it did not improve for 7 days after surgery. Chest computed tomography (CT) revealed a hemothorax and a large sharp bone cement fragment that perforated the right atrium. Bone cement can be removed with thoracotomy surgery. We have to be aware of cement leakage through the normal venous drain system around the vertebral body. We also have to consider a detailed cardiac workup, which may include chest CT or echocardiography, if a patient complains of chest pain or dyspnea after cement augmentation.