Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerations

We report the case of a 61-year-old female with metastatic rectal adenocarcinoma who underwent surgical fixation and laminectomy for an L3 vertebral compression fracture. Pedicle screws were augmented with cement. Follow-up computed tomography later detected an incidental pulmonary cement embolism i...

Full description

Saved in:
Bibliographic Details
Main Authors: Mohammad Daher, BS, Victor Percheron, MD, Adrien Lampilas, MD, Amer Sebaaly, MD, Guillaume Riouallon, MD, Stéphanie Bonhomme, MD, Maxime Delrue, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468428725001273
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849408672046776320
author Mohammad Daher, BS
Victor Percheron, MD
Adrien Lampilas, MD
Amer Sebaaly, MD
Guillaume Riouallon, MD
Stéphanie Bonhomme, MD
Maxime Delrue, MD, PhD
author_facet Mohammad Daher, BS
Victor Percheron, MD
Adrien Lampilas, MD
Amer Sebaaly, MD
Guillaume Riouallon, MD
Stéphanie Bonhomme, MD
Maxime Delrue, MD, PhD
author_sort Mohammad Daher, BS
collection DOAJ
description We report the case of a 61-year-old female with metastatic rectal adenocarcinoma who underwent surgical fixation and laminectomy for an L3 vertebral compression fracture. Pedicle screws were augmented with cement. Follow-up computed tomography later detected an incidental pulmonary cement embolism in the right pulmonary artery. The patient remained asymptomatic and was managed with anticoagulation therapy. Subsequent gastrointestinal bleeding required temporary cessation of anticoagulation, but prophylactic anticoagulation was resumed due to the persistent embolus. At 6-month follow-up, the patient remained stable without hemorrhagic complications. In asymptomatic central pulmonary cement embolisms, anticoagulation may be appropriate but requires careful risk assessment and multidisciplinary management to balance the risks of thrombosis and bleeding.
format Article
id doaj-art-408db6f2033d45138bb36cb7e78b8ce2
institution Kabale University
issn 2468-4287
language English
publishDate 2025-08-01
publisher Elsevier
record_format Article
series Journal of Vascular Surgery Cases and Innovative Techniques
spelling doaj-art-408db6f2033d45138bb36cb7e78b8ce22025-08-20T03:35:44ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872025-08-0111410184510.1016/j.jvscit.2025.101845Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerationsMohammad Daher, BS0Victor Percheron, MD1Adrien Lampilas, MD2Amer Sebaaly, MD3Guillaume Riouallon, MD4Stéphanie Bonhomme, MD5Maxime Delrue, MD, PhD6Orthopedic Department, Hotel Dieu de France, Beirut, Lebanon; Orthopedic Department, Brown University, Providence, RIVascular Medicine Department, Hôpitaux Paris Saint-Joseph et Marie-Lannelongue, Paris, FranceOrthopedic Department, Hôpitaux Paris Saint-Joseph et Marie-Lannelongue, Paris, FranceOrthopedic Department, Hotel Dieu de France, Beirut, LebanonOrthopedic Department, Hôpitaux Paris Saint-Joseph et Marie-Lannelongue, Paris, FranceVascular Medicine Department, Hôpitaux Paris Saint-Joseph et Marie-Lannelongue, Paris, FranceVascular Medicine Department, Hôpitaux Paris Saint-Joseph et Marie-Lannelongue, Paris, France; Inserm UMR-S 1144, Université de Paris Cité, Paris, France; Correspondence: Maxime Delrue, MD, Vascular Medicine Department, Hôpitaux Paris Saint-Joseph et Marie-Lannelongue, Inserm UMR-S 1144, Université de Paris Cité, 185 Rue Raymond Losserand, Paris 75014, FranceWe report the case of a 61-year-old female with metastatic rectal adenocarcinoma who underwent surgical fixation and laminectomy for an L3 vertebral compression fracture. Pedicle screws were augmented with cement. Follow-up computed tomography later detected an incidental pulmonary cement embolism in the right pulmonary artery. The patient remained asymptomatic and was managed with anticoagulation therapy. Subsequent gastrointestinal bleeding required temporary cessation of anticoagulation, but prophylactic anticoagulation was resumed due to the persistent embolus. At 6-month follow-up, the patient remained stable without hemorrhagic complications. In asymptomatic central pulmonary cement embolisms, anticoagulation may be appropriate but requires careful risk assessment and multidisciplinary management to balance the risks of thrombosis and bleeding.http://www.sciencedirect.com/science/article/pii/S2468428725001273Cement embolismVertebral compression fracturesMetastasis
spellingShingle Mohammad Daher, BS
Victor Percheron, MD
Adrien Lampilas, MD
Amer Sebaaly, MD
Guillaume Riouallon, MD
Stéphanie Bonhomme, MD
Maxime Delrue, MD, PhD
Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerations
Journal of Vascular Surgery Cases and Innovative Techniques
Cement embolism
Vertebral compression fractures
Metastasis
title Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerations
title_full Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerations
title_fullStr Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerations
title_full_unstemmed Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerations
title_short Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerations
title_sort pulmonary cement embolism following cement augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture a case report and management considerations
topic Cement embolism
Vertebral compression fractures
Metastasis
url http://www.sciencedirect.com/science/article/pii/S2468428725001273
work_keys_str_mv AT mohammaddaherbs pulmonarycementembolismfollowingcementaugmentedpediclescrewfixationinapatientwithmetastaticvertebralcompressionfractureacasereportandmanagementconsiderations
AT victorpercheronmd pulmonarycementembolismfollowingcementaugmentedpediclescrewfixationinapatientwithmetastaticvertebralcompressionfractureacasereportandmanagementconsiderations
AT adrienlampilasmd pulmonarycementembolismfollowingcementaugmentedpediclescrewfixationinapatientwithmetastaticvertebralcompressionfractureacasereportandmanagementconsiderations
AT amersebaalymd pulmonarycementembolismfollowingcementaugmentedpediclescrewfixationinapatientwithmetastaticvertebralcompressionfractureacasereportandmanagementconsiderations
AT guillaumeriouallonmd pulmonarycementembolismfollowingcementaugmentedpediclescrewfixationinapatientwithmetastaticvertebralcompressionfractureacasereportandmanagementconsiderations
AT stephaniebonhommemd pulmonarycementembolismfollowingcementaugmentedpediclescrewfixationinapatientwithmetastaticvertebralcompressionfractureacasereportandmanagementconsiderations
AT maximedelruemdphd pulmonarycementembolismfollowingcementaugmentedpediclescrewfixationinapatientwithmetastaticvertebralcompressionfractureacasereportandmanagementconsiderations