Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentation

BackgroundCement leakage into the inferior vena cava (IVC) is one of the most common complications associated with cement vertebroplasty, and can lead to potentially life-threatening complications such as pulmonary cement embolism (PCE). Implantation of an IVC filter is effective in the prevention o...

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Main Authors: Xinqiang Han, Yongzhen Zhang, Zhu Wang, Mengpeng Zhao
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-09-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2022.892025/full
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author Xinqiang Han
Yongzhen Zhang
Zhu Wang
Mengpeng Zhao
author_facet Xinqiang Han
Yongzhen Zhang
Zhu Wang
Mengpeng Zhao
author_sort Xinqiang Han
collection DOAJ
description BackgroundCement leakage into the inferior vena cava (IVC) is one of the most common complications associated with cement vertebroplasty, and can lead to potentially life-threatening complications such as pulmonary cement embolism (PCE). Implantation of an IVC filter is effective in the prevention of fatal pulmonary embolism. Here, we present an extremely rarely case of cement entrapped in an IVC filter after pedicle screw augmentation, and discuss all similar cases reported in the literature.Case presentationA 70-year-old female presented with significant back and lower extremities pain and was unable to walk. MRI of the lumbar spine revealed an osteoporotic compression fracture of the L1–L3. She underwent cement-augmented pedicle screws implanted at the L1 and L3 vertebral bodies. A retrievable IVC filter was implanted due to the presence of calf vein thrombosis before cement vertebroplasty. Cement leaked into the IVC and was trapped by the filter, rendering the filter unretrievable using a conventional method. The asymptomatic patient received rivaroxaban 20 mg daily for anticoagulant postoperatively and lifelong anticoagulation was administered to prevent secondary IVC and cemented filter thrombosis.MethodsA literature search was conducted utilizing the PUBMED/MEDLINE using the following terms: “vertebroplasty,” “complication,” “bone cement,” and “inferior vena cava (IVC),” or “inferior vena cava (IVC) filter.” All relevant articles published in English or in other languages with English abstracts since 1962 were included.ResultsA total of 36 articles were retrieved according to the search strategy. Only 6 out of these 36 studies contained information regarding the inferior vena cava filter and cement. Of the patients, 85.7% (36/42) reported in the literature whose gender was known were female and 14.3% were male. 28.5% (45/158) patients with pulmonary arterial and cardiovascular complications.ConclusionCement embolization occurring in the IVC filter is rare. Accurate knowledge about the lumbar vertebral venous anatomy and skillful operation during vertebral cementoplasty should be required in clinical practice.
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spelling doaj.art-4ed98a9adb224fa0b304f7243ebb12402022-12-22T04:32:32ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-09-01910.3389/fcvm.2022.892025892025Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentationXinqiang HanYongzhen ZhangZhu WangMengpeng ZhaoBackgroundCement leakage into the inferior vena cava (IVC) is one of the most common complications associated with cement vertebroplasty, and can lead to potentially life-threatening complications such as pulmonary cement embolism (PCE). Implantation of an IVC filter is effective in the prevention of fatal pulmonary embolism. Here, we present an extremely rarely case of cement entrapped in an IVC filter after pedicle screw augmentation, and discuss all similar cases reported in the literature.Case presentationA 70-year-old female presented with significant back and lower extremities pain and was unable to walk. MRI of the lumbar spine revealed an osteoporotic compression fracture of the L1–L3. She underwent cement-augmented pedicle screws implanted at the L1 and L3 vertebral bodies. A retrievable IVC filter was implanted due to the presence of calf vein thrombosis before cement vertebroplasty. Cement leaked into the IVC and was trapped by the filter, rendering the filter unretrievable using a conventional method. The asymptomatic patient received rivaroxaban 20 mg daily for anticoagulant postoperatively and lifelong anticoagulation was administered to prevent secondary IVC and cemented filter thrombosis.MethodsA literature search was conducted utilizing the PUBMED/MEDLINE using the following terms: “vertebroplasty,” “complication,” “bone cement,” and “inferior vena cava (IVC),” or “inferior vena cava (IVC) filter.” All relevant articles published in English or in other languages with English abstracts since 1962 were included.ResultsA total of 36 articles were retrieved according to the search strategy. Only 6 out of these 36 studies contained information regarding the inferior vena cava filter and cement. Of the patients, 85.7% (36/42) reported in the literature whose gender was known were female and 14.3% were male. 28.5% (45/158) patients with pulmonary arterial and cardiovascular complications.ConclusionCement embolization occurring in the IVC filter is rare. Accurate knowledge about the lumbar vertebral venous anatomy and skillful operation during vertebral cementoplasty should be required in clinical practice.https://www.frontiersin.org/articles/10.3389/fcvm.2022.892025/fullvertebroplastybone cementinferior vena cavainferior vena cava filtercomplication
spellingShingle Xinqiang Han
Yongzhen Zhang
Zhu Wang
Mengpeng Zhao
Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentation
Frontiers in Cardiovascular Medicine
vertebroplasty
bone cement
inferior vena cava
inferior vena cava filter
complication
title Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentation
title_full Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentation
title_fullStr Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentation
title_full_unstemmed Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentation
title_short Case report: Cement entrapped in the inferior vena cava filter after pedicle screw augmentation
title_sort case report cement entrapped in the inferior vena cava filter after pedicle screw augmentation
topic vertebroplasty
bone cement
inferior vena cava
inferior vena cava filter
complication
url https://www.frontiersin.org/articles/10.3389/fcvm.2022.892025/full
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