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

Spine (Phila Pa 1976). 2004 Jul 15;29(14):E294-7. doi: 10.1097/01.brs.0000131211.87594.b0.


Study design: A case of acute respiratory distress syndrome following percutaneous vertebroplasty is described.

Objective: To alert clinicians to the potential occurrence of acute respiratory distress syndrome following use of polymethylmethacrylate bone cement.

Summary of background data: Noncardiogenic pulmonary edema has not been reported following intravertebral injection of polymethylmethacrylate.

Methods: 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.

Results: 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.

Conclusion: This case illustrates that clinicians must be aware of the potential occurrence of acute respiratory distress syndrome in patients who received percutaneous vertebroplasty.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bone Cements / adverse effects*
  • Embolectomy
  • Fatal Outcome
  • Female
  • Fractures, Spontaneous / etiology
  • Fractures, Spontaneous / therapy*
  • Humans
  • Injections, Intralesional
  • Multiple Organ Failure / etiology
  • Osteoporosis / complications
  • Polymethyl Methacrylate / administration & dosage
  • Polymethyl Methacrylate / adverse effects*
  • Pulmonary Artery
  • Pulmonary Embolism / chemically induced*
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / surgery
  • Respiratory Distress Syndrome / etiology*
  • Spinal Fractures / etiology
  • Spinal Fractures / therapy*
  • Treatment Failure


  • Bone Cements
  • Polymethyl Methacrylate