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Keywords:
Interventional non-vascular, Musculoskeletal spine, Lung, CT, Digital radiography, Fluoroscopy, Vertebroplasty, Outcomes analysis, Statistics, Outcomes, Osteoporosis, Drugs / Reactions
Authors:
A. A. Fares1, I. Willekens1, S. Alard1, S. A. Z. Khodair2, C. G. Boulet1, M. Moens1, M. De Maeseneer1, J. de Mey1; 1Brussels/BE, 2Qwuesna/EG
DOI:
10.1594/ecr2015/C-0860
Methods and materials
We retrospectively reviewed the database of our department for patients who underwent percutaneous balloon kyphoplasty between April,
2010,
and June 2014.
Only those patients who underwent CT scans or radiographs of the chest after the date of kyphoplasty were selected: 68 patients with 162 levels for balloon kyphoplasty (45 women,
23 men; mean age,
73.19 years (range,
33–97 years)).
Each patient underwent at least one computed tomography (CT) scan of treated vertebrae obtained post-operatively for control.
We categorized them into 2 groups: patients in the first group underwent CT scans of the chest (39 patients),
patients in the second group had only chest radiographs (29 patients) (Fig.
4).
All patients enrolled in this study were operated under fluoroscopic guidance with nearly the same technical conditions.
Cement used in balloon kyphoplasty contains at least 30% barium,
which helps to differentiate it from adjacent lung parenchyma or other pulmonary calcifications 9.
The following criteria have been used to detect cement pulmonary embolism (CPE): Any branching high attenuation area which is smaller than the proximal luminal diameter of pulmonary artery or located on the expected course of the pulmonary artery. A newly developed branching high attenuation area which is absent in preoperative chest CT or radiographs 10.
The presence and location of cement pulmonary embolism,
sex and age of patient,
level and number of treated vertebrae were analyzed using different types of statistical tests.
Evaluation of the following risk factors for pulmonary cement embolism has been done:
- Presence or absence of paravertebral cement leakage.
- Presence or absence of cement leak in the azygos vein.
- Presence or absence of air-filled vertebral cleft above or below the level of the kyphoplasty.
- Presence or absence of bipedicular approach of kyphoplasty.
- Presence or absence of osteoporotic fractures.
We systematically reviewed the medical literature to compare it with our incidence of cement pulmonary embolism (Fig.
5).