Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate.

Abstract

A case of acute respiratory distress syndrome following percutaneous vertebroplasty is described. To alert clinicians to the potential occurrence of acute respiratory distress syndrome following use of polymethylmethacrylate bone cement. Noncardiogenic pulmonary edema has not been reported following intravertebral injection of polymethylmethacrylate. A 68-year-old woman underwent percutaneous vertebroplasty for a painful L5 compression fracture under local anesthesia. A contralateral transpedicular approach was made to inject polymethylmethacrylate. On the third postoperative day, she developed arthralgia, myalgia, fever, and frequent coughing. Chest radiography revealed bilateral, multifocal, patchy consolidations, suggestive of acute respiratory distress syndrome, and a 5-cm-long tubular radiopacity in the right pulmonary artery. She died 20 days after the vertebroplasty. This case illustrates that clinicians must be aware of the potential occurrence of acute respiratory distress syndrome in patients who received percutaneous vertebroplasty.