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A 71-year-old woman was admitted to hospital after a car crash and diagnosed with L1 vertebral body fracture. A percutaneous transpedicular lumbar fixation using polymethylmethacrylate (PMMA) cement was decided. During the procedure, a massive PMMA cement leakage into the paravertebral venous system was observed. Hypotension, acute respiratory distress and refractory hypoxaemia were rapidly manifested. A cement pulmonary embolism was suspected and an unenhanced CT performed. A large collection of PMMA fragments were distinguished in the right pulmonary artery (RPA) and lobar branches (figure …
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