by Ozge Gumusay, Laura A. Huppert, Spencer C. Behr, Hope S.
Rugo
The Breast: Published: April 01, 2022
Abstract
Patients with metastatic breast cancer are at high risk for
developing vertebral compression fractures due to underlying bone metastases
and bone density loss. Vertebral augmentation techniques including percutaneous
vertebroplasty and percutaneous balloon kyphoplasty are techniques used to
stabilize compression fractures and improve pain. However, rare complications
from these interventions have been observed, including spinal cord compression,
nerve root compression, venous cement embolism, and pulmonary cement embolism.
These complications pose unique potential challenges for patients with cancer
who may already have decreased lung function and potential for venous
thromboembolism. In this review, we first describe the role of percutaneous
vertebral augmentations in patients with metastatic cancer, with a particular
focus on patients with breast cancer. Then, we describe complications of
vertebral augmentation in two patients with metastatic breast cancer including
long-term symptomatic and radiographic follow-up.
Highlights
•Balloon kyphoplasty and percutaneous vertebroplasty are
used to stabilize compression fractures and improve pain.
•Leakage of bone cement can cause cement emboli which can
depsit in locations such as the pulmonary and renal vasculature.
•Management of cement emboli depends on the amount of cement
embolized and the severity of symptoms.
•Future studies are needed to better understand the long-term
radiographic and clinical consequences of cement emboli.
