Putative risk of substantial venous air embolism during vertebroplasty: A technical observation

STUDY DESIGN. Technical report. OBJECTIVE. To convey the mechanism of venous air embolism (VAE) during percutaneous spinal procedures and its proper identification and management. SUMMARY OF BACKGROUND DATA. Percutaneous spinal procedures such as vertebroplasty and kyphoplasty are commonplace techniques employed to alleviate back pain for compression fractures. VAE is a real and likely underappreciated phenomenon that is important to recognize. METHODS. A case report is used to illustrate the clinical scenario of VAE during vertebroplasty performed for a T9 compression fracture. RESULTS. The rapid sumping of fluid and air was identified during the procedure and believed to be due to a large air/venous interface within the trabecular bone. The needle was capped and no undue harm occurred to the patient. CONCLUSION. VAE is a complication with associated morbidity and mortality from percutaneous procedures for the treatment of compression fractures. An understanding of the causes, prevention, identification, and management when it occurs will serve to improve patient care and reduce morbidity.