PMC8571380_01
(a) Computed tomography, sagittal view, transverse fracture of T11, subluxation of the vertebral body. (b) T2-weighted magnetic resonance imaging, sagittal view, injury of the posterior ligament complex. (c) Computed axial tomography, axial view, double image of vertebral laminae due to subluxation.
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F1
T11 traumatic spinal injury as a result of falling backwards downstairs. The computed tomography (CT) scan showed a T11, AO spine C classification, without a neurological deficit, ASIA - E [Figure 1].
(a) Intraoperative, instrumental placement for cement application. (b) Fluoroscopy, sagittal view, transpedicular screw placement. (c) Augmentation begins, bone cement at the level of the vertebral body. (d) Suspected bone cement leakage through the paravertebral venous system.
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F2
When the fourth screw was placed, fluoroscopy showed leakage of PMMA cement into the paravertebral system [Figure 2].
Computed axial tomography Angiography, (a-c) Coronal, sagittal, and axial view (yellow circle), respectively where high density material is observed in the paravertebral venous system, is suggestive of cement embolus. (d) Presence of the high density material occupying the lumen of the subsegmental arterial vessels, in the apicoposterior segment of both upper lobes, anterior segment of the right upper lobe, lingula lobe, middle lobe, posterior and medial basal, segment of the right lower lobe.
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F3
The CT angiogram of the chest documented a cement pulmonary embolism [Figure 3].
Follow-up at 1 week after surgery. Instrumentation with transpedicular screws at T9, T10, T12 and L1 with polymethylmethacrylate augmentation. (a) Anteroposterior view, radiopaque image in right lung associated with cement emboli. (b) sagittal view radiopaque image which is correlated with cement leakage through the paravertebral venous system.
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F4
Nine days later, she had a postoperative Chest X-ray that showed a radiopaque image in the right lung associated with cement emboli [Figure 4].