Radiologic features of pulmonary cement embolism after percutaneous vertebroplasty in a case and review of literature

Percutaneous vertebroplasty is a well-known treatment modality for vertebral compression fractures caused by osteoporosis and malignant metastases. The procedure involves the injection of polymethyl methacrylate (PMMA, bone cement), into the desired vertebral body. Pulmonary cement embolism (PCE) refers to the embolization of PMMA into the pulmonary arteries. Patients are often asymptomatic and it may be detected incidentally for imaging done for another reason. The most common symptoms of pulmonary cement embolization are chest pain and breathlessness, and rarely it can present as acute respiratory distress syndrome. In this case, we aimed to present a 73-year-old male patient of PCE with computed tomography (CT) images. We want to raise the awareness that all patients undergoing vertebroplasty procedure should have routine chest X-ray after the procedure. However, CT is the best modality to determine PCE.