Cement leakage and pulmonary embolism by bone cement-augmented pedicle screw fixation of the thoracolumbar spine – A case report

Background: Few studies discuss the complication of pulmonary cement embolism (PCE) due to cement augmented pedicle screw instrumentation (CAPSI) of the thoracolumbar spine. Case Description: A 62 female with a history of multiple myeloma and Sjogren’s syndrome on chronic steroids developed an osteoporotic L1 compression fracture and underwent posterior stabilization with a T10–L4 CAPSI. However, postoperatively, the patient developed a surgical site infection and a PCE, resulting in severe respiratory compromise and death 1 month later. Conclusion: When performing a T10–L4 thoracolumbar CAPSI (i.e., augmented pedicle screw instrumentation of the thoracolumbar spine) to address an L1 osteoporotic compression fracture, a 62 year old patient developed a life ending multi organ deficiency due to sepsis together with a PCE.