Case of cement leaking in man’s heart during kyphoplasty
In an unusual case, a foreign body perforated a 56-year-old’s arteries after a spinal cord surgery. The patient presented with a vertebral compression fracture in the lumbar region just above the sacrum. Doctors advised kyphoplasty to repair the vertebra. In this procedure, the surgeon inserts a special cement into the vertebra through a space created with a ballon-like device. Kyphoplasty is a standard procedure for restoring a damaged vertebra’s height and may also relieve pain. The doctor inserts a needle through your skin and back muscles into the bone.
5 days after the procedure the patient returned to the hospital with radiating chest pain
However, all medical procedures have their risks. In this procedure there is a slight risk of the cement leaking into the surrounding tissues. 5 days after the spinal procedure the patient returned to the hospital with a complaint of chest pain radiating to the jaw and shoulder on his right side. Doctors advised an X-ray and a computed tomography of the chest which showed a foreign body in the artery.
The patient was immediately referred to surgery for an emergency cardiothoracic procedure. After assessing the extent of the damage, the doctors were able to conclude that the foreign body was a cement embolism, measuring 10.1 centimeters (4 inches) in length and 2 millimeters in diameter. In addition, the foreign body had also perforated the right atrium and travelled past the pericardium into the sac surrounding the heart, puncturing the patient’s right lung. Depending on your medical condition, kyphoplasty has several risks including, infection, bleeding, increased back pain, tinging and numbness because of nerve damage, and cement leaking out.
Fortunately, the surgeons were able to remove the cement embolus and repair the damage to the heart. The patient had an uneventful recovery and showed full recovery after a month of the procedure.
Source: NEJM
