Life-Threatening Cardiac Perforation After Posterior Spondylodesis.

This reports presents a case of a 62-year-old woman with hemorrhagic hypovolemic shock, respiratory distress, and pericardial effusion secondary to right atrial perforation caused by a cement embolus after dorsal spondylodesis. Despite optimal intensive care support for a supposed pulmonary embolism, the patient's condition markedly deteriorated. On delayed embolus recognition by contrast-enhanced computed tomography and transesophageal echocardiography, she had to undergo cardiac surgery. Cardiac involvement is a rare but important complication, with few cases described after vertebroplasty and none after spondylodesis. In our case, diagnosis before perforation would have allowed an endovascular approach, thereby avoiding open heart surgery.