Intracardiac, pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation: A case report and review of literature

Table 1 A timeline of the patient

Date	Oxygen saturation	Platelets, 109/L	WBC, 109/L	Hemoglobin, g/L	D-dimer, ng/mL	Clinical intervention
March 13, 2017	99%	172	6.75	121	631	Admission
March 23, 2017	99%	-	-	-	-	Lumbar surgery
March 24, 2017	99%	158	14.27	96	7698.90	Vital signs monitering
March 25, 2017	70%	113	12.4	84		Pulmonary expert consultation
March 26, 2017	85%	121	8.90	85	5667	Levofloxacin 500 mg qd+ LMWH 5000 IU qd
April 1, 2017	98%	-	-	-	-	Levofloxacin 500 mg qd+ LMWH 5000 IU qd
April 14, 2017	98%	-	-	-	4638	Discharged

WBC: White blood cell; LMWH: Low molecular weight heparin.

Table 2 Summary of reported cardiopulmonary embolism caused by cement-augmented pedicle screw instrumentation

Ref.	Sex	Age	Vertebrae augmented	Time of embolism detected Post-op	Clinical presentation	Treatment	Outcome
Rasch et al[20], 2010	M	55	L3/4	2 d	Tachycardia, dyspnea and oxygen desaturation	Pulmonary arteriotomy and cement removement	Discharged without severe complication
Tang et al[21], 2020	F	73	L3-L5	6 d	Dyspnea, blood oxygen desaturation	Oxygen inhalation and anticoagulation treatment	Uneventful recovery in 2 yr follow-up
Akinola et al[22], 2010	M	76	L3-L5	Immediate	No symptoms	Anticoagulation treatment for 6 mo	Uneventful recovery in 6 mo follow-up
Zheng et al[23], 2013	F	47	T1-T4, T9	1 h	Dyspnea, low blood pressure, unconsciousness	NA	Death
Rahimizadeh et al[24], 2020	F	NA (middle aged)	L3	1 d	Cardiopulmonary arrest	Resuscitation, anticoagulation treatment	Uneventful recovery in 12 mo follow-up
Röllinghoff et al[25], 2010	F	69	T8-L1	NA	No symptoms	NA	Uneventful recovery in 18 mo follow-up
Tonolini et al[26], 2012	F	75	L1/L3	Immediate	Dyspnea with tachypnea and bilateral hypoventilation	Anticoagulation treatment	Discharged without severe complication

NA: Not applicable.