Pulmonary cement embolism is not associated with the cause of death in a post-mortem cohort of cement-augmented interventions in the spine
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Pulmonary cement embolism is not associated with the cause of death in a post-mortem cohort of cement-augmented interventions in the spine. / Butscheidt, Sebastian; Rolvien, Tim; Ritter, Jakob; Heinemann, Axel; Vogel, Hermann; Amling, Michael; Püschel, Klaus.
In: EUR SPINE J, Vol. 27, No. 10, 10.2018, p. 2593-2601.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Pulmonary cement embolism is not associated with the cause of death in a post-mortem cohort of cement-augmented interventions in the spine
AU - Butscheidt, Sebastian
AU - Rolvien, Tim
AU - Ritter, Jakob
AU - Heinemann, Axel
AU - Vogel, Hermann
AU - Amling, Michael
AU - Püschel, Klaus
PY - 2018/10
Y1 - 2018/10
N2 - PURPOSE: Complications of cement-augmented interventions (e.g., kyphoplasty) in the spine include local cement leakage and pulmonary cement embolisms (PCE). This study was conducted to determine their extent in a unique post-mortem cohort.METHODS: Retrospective analysis of post-mortem whole-body CT scans and review of autopsy results in 29 consecutive cases with cement-augmented interventions in the spine. PCE findings were graded based on cement deposits: grade 0 (no PCE), grade 1 (1-3 PCE), grade 2 (4-6 PCE), and grade 3 (> 6 or branch-shaped PCE). Bone and lung tissue specimens were obtained in representative cases to confirm the findings histologically.RESULTS: Local cement leakage was detected in 69%: intravenous (34%), intervertebral (31%), intraspinal (14%), and retrograde (17%). Lung sections showed PCE in 52%: grade 0 (48%), grade 1 (31%), grade 2 (10%), and grade 3 (10%). Matching with autopsy findings revealed that none of the cases died due to the impact of PCE.CONCLUSIONS: The presented data reveal a high frequency of PCE making it a notable finding-especially since not only single but also branch-like embolisms were detected. Thus, it is of great importance that none of the causes of death were related to the impact of PCE. Nevertheless, it is crucial to consider the underlying diseases for increased PCE risk and to apply latest surgical techniques and preventive measures. These slides can be retrieved under Electronic Supplementary material.
AB - PURPOSE: Complications of cement-augmented interventions (e.g., kyphoplasty) in the spine include local cement leakage and pulmonary cement embolisms (PCE). This study was conducted to determine their extent in a unique post-mortem cohort.METHODS: Retrospective analysis of post-mortem whole-body CT scans and review of autopsy results in 29 consecutive cases with cement-augmented interventions in the spine. PCE findings were graded based on cement deposits: grade 0 (no PCE), grade 1 (1-3 PCE), grade 2 (4-6 PCE), and grade 3 (> 6 or branch-shaped PCE). Bone and lung tissue specimens were obtained in representative cases to confirm the findings histologically.RESULTS: Local cement leakage was detected in 69%: intravenous (34%), intervertebral (31%), intraspinal (14%), and retrograde (17%). Lung sections showed PCE in 52%: grade 0 (48%), grade 1 (31%), grade 2 (10%), and grade 3 (10%). Matching with autopsy findings revealed that none of the cases died due to the impact of PCE.CONCLUSIONS: The presented data reveal a high frequency of PCE making it a notable finding-especially since not only single but also branch-like embolisms were detected. Thus, it is of great importance that none of the causes of death were related to the impact of PCE. Nevertheless, it is crucial to consider the underlying diseases for increased PCE risk and to apply latest surgical techniques and preventive measures. These slides can be retrieved under Electronic Supplementary material.
KW - Journal Article
U2 - 10.1007/s00586-018-5581-5
DO - 10.1007/s00586-018-5581-5
M3 - SCORING: Journal article
C2 - 29667142
VL - 27
SP - 2593
EP - 2601
JO - EUR SPINE J
JF - EUR SPINE J
SN - 0940-6719
IS - 10
ER -