Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases
ObjectivePulmonary cement embolism is a rare but underestimated complication of vertebroplasty due to the relative lack of study and examination. This study aims to investigate the incidence of pulmonary cement embolism in patients with spinal metastasis who undergo PVP with RFA and to analyze the r...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-05-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1129658/full |
| _version_ | 1797833041865867264 |
|---|---|
| author | Luqiang Wang Ming Lu Xinxin Zhang Zhenguo Zhao Xiaoyang Li Ting Liu Libin Xu Shengji Yu |
| author_facet | Luqiang Wang Ming Lu Xinxin Zhang Zhenguo Zhao Xiaoyang Li Ting Liu Libin Xu Shengji Yu |
| author_sort | Luqiang Wang |
| collection | DOAJ |
| description | ObjectivePulmonary cement embolism is a rare but underestimated complication of vertebroplasty due to the relative lack of study and examination. This study aims to investigate the incidence of pulmonary cement embolism in patients with spinal metastasis who undergo PVP with RFA and to analyze the relative risk factors.MethodsA total of 47 patients were retrospectively included and classified into pulmonary cement embolism (PCE) group and non-pulmonary cement embolism (NPCE) group by comparing pre- and postoperative pulmonary CT scan images. The demographic and clinical information of the patients was obtained. Demographic data in the two groups were compared using the chi-square test for qualitative data and the unpaired t test for quantitative data. Multiple logistic regression analysis was used to identify risk factors related to pulmonary cement embolism.ResultsPulmonary cement embolism was detected in 11 patients (23.4%), and all patients were asymptomatic and followed up regularly. Risk analysis showed that multiple segments (≥3, p=0.022), thoracic vertebrae (p=0.0008), and unipedicular puncture approach (p=0.0059) were risk factors for pulmonary cement embolism. There was a high incidence of pulmonary cement embolism if bone cement leaked into the para vertebral venous plexus in the thoracic vertebra (p<0.0001). Vein leakage of cement was related to the integrity of the vertebral cortex.ConclusionThe number of involved vertebrae, lesion location, and puncture approach are independent risk factors for pulmonary cement embolism. There was a high incidence of pulmonary cement embolism if bone cement leaked into the para vertebral venous plexus in the thoracic vertebra. Surgeons should consider these factors when formulating therapeutic strategies. |
| first_indexed | 2024-04-09T14:17:21Z |
| format | Article |
| id | doaj.art-6627018dcb2b444fb9d88016c58c0897 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T14:17:21Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-6627018dcb2b444fb9d88016c58c08972023-05-05T05:57:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-05-011310.3389/fonc.2023.11296581129658Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastasesLuqiang Wang0Ming Lu1Xinxin Zhang2Zhenguo Zhao3Xiaoyang Li4Ting Liu5Libin Xu6Shengji Yu7Department of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Orthopedics, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaObjectivePulmonary cement embolism is a rare but underestimated complication of vertebroplasty due to the relative lack of study and examination. This study aims to investigate the incidence of pulmonary cement embolism in patients with spinal metastasis who undergo PVP with RFA and to analyze the relative risk factors.MethodsA total of 47 patients were retrospectively included and classified into pulmonary cement embolism (PCE) group and non-pulmonary cement embolism (NPCE) group by comparing pre- and postoperative pulmonary CT scan images. The demographic and clinical information of the patients was obtained. Demographic data in the two groups were compared using the chi-square test for qualitative data and the unpaired t test for quantitative data. Multiple logistic regression analysis was used to identify risk factors related to pulmonary cement embolism.ResultsPulmonary cement embolism was detected in 11 patients (23.4%), and all patients were asymptomatic and followed up regularly. Risk analysis showed that multiple segments (≥3, p=0.022), thoracic vertebrae (p=0.0008), and unipedicular puncture approach (p=0.0059) were risk factors for pulmonary cement embolism. There was a high incidence of pulmonary cement embolism if bone cement leaked into the para vertebral venous plexus in the thoracic vertebra (p<0.0001). Vein leakage of cement was related to the integrity of the vertebral cortex.ConclusionThe number of involved vertebrae, lesion location, and puncture approach are independent risk factors for pulmonary cement embolism. There was a high incidence of pulmonary cement embolism if bone cement leaked into the para vertebral venous plexus in the thoracic vertebra. Surgeons should consider these factors when formulating therapeutic strategies.https://www.frontiersin.org/articles/10.3389/fonc.2023.1129658/fullspinal metastasespulmonary cement embolismPVPRFA - radiofrequency ablationcement vein leakage |
| spellingShingle | Luqiang Wang Ming Lu Xinxin Zhang Zhenguo Zhao Xiaoyang Li Ting Liu Libin Xu Shengji Yu Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases Frontiers in Oncology spinal metastases pulmonary cement embolism PVP RFA - radiofrequency ablation cement vein leakage |
| title | Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases |
| title_full | Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases |
| title_fullStr | Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases |
| title_full_unstemmed | Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases |
| title_short | Risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases |
| title_sort | risk factors for pulmonary cement embolism after percutaneous vertebroplasty and radiofrequency ablation for spinal metastases |
| topic | spinal metastases pulmonary cement embolism PVP RFA - radiofrequency ablation cement vein leakage |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1129658/full |
| work_keys_str_mv | AT luqiangwang riskfactorsforpulmonarycementembolismafterpercutaneousvertebroplastyandradiofrequencyablationforspinalmetastases AT minglu riskfactorsforpulmonarycementembolismafterpercutaneousvertebroplastyandradiofrequencyablationforspinalmetastases AT xinxinzhang riskfactorsforpulmonarycementembolismafterpercutaneousvertebroplastyandradiofrequencyablationforspinalmetastases AT zhenguozhao riskfactorsforpulmonarycementembolismafterpercutaneousvertebroplastyandradiofrequencyablationforspinalmetastases AT xiaoyangli riskfactorsforpulmonarycementembolismafterpercutaneousvertebroplastyandradiofrequencyablationforspinalmetastases AT tingliu riskfactorsforpulmonarycementembolismafterpercutaneousvertebroplastyandradiofrequencyablationforspinalmetastases AT libinxu riskfactorsforpulmonarycementembolismafterpercutaneousvertebroplastyandradiofrequencyablationforspinalmetastases AT shengjiyu riskfactorsforpulmonarycementembolismafterpercutaneousvertebroplastyandradiofrequencyablationforspinalmetastases |