Asian Spine J.  2014 Apr;8(2):197-201. 10.4184/asj.2014.8.2.197.

Intraoperative Life Threatening Acute Lung Injury Due to Multiple Septic Pulmonary Emboli during Transpedicular Biopsy and Kyphoplasty

• Karthik K
• Shetty AP
• Rajasekaran S

• KMID: 2270375
• DOI: http://doi.org/10.4184/asj.2014.8.2.197

Abstract

A 55-year-old gentleman was presented to our clinic two months after a trivial fall with persistent pain, gibbus at the thoraco-lumbar junction and intact neurology. Radiological and laboratory investigations suggested osteoporotic fracture or metastasis. Due to unremitting pain, a plan was made to do transpedicular biopsy and kyphoplasty. Biopsy needles were inserted into both pedicles and an attempt at aspiration was made. Since the aspirate was dry, 5 to 6 mL of saline was injected through one needle and an attempt at aspiration was made through the other. Three-millilitres of sero-sanguineous material mixed with pus came out and kyphoplasty was deferred. After extubation, the patient developed severe bronchospasm and was transferred to the intensive care unit. Investigations confirmed multiple septic pulmonary emboli and the patient recovered completely after treatment. This report highlights that confirmation of the diagnosis is essential before performing any procedure that increases the intravertebral pressure and the place should have appropriate facilities to manage complications.

Keyword

Transpedicular biopsy; Kyphoplasty; Septic pulmonary emboli; Acute lung injury; Infective spondylitis

MeSH Terms

Acute Lung Injury*
Biopsy*
Bronchial Spasm
Diagnosis
Humans
Intensive Care Units
Kyphoplasty*
Middle Aged
Needles
Neoplasm Metastasis
Neurology
Osteoporotic Fractures
Suppuration