Dyspnea After Spinal Surgery and a Troubling X-Ray

An older woman developed dyspnea after instrumented lumbar spinal fusion surgery. During clinical work-up, a chest radiography revealed a U-shaped object within the cardiac silhouette. Further imaging confirmed that the object was entrapped in the tricuspid subvalvular apparatus. Surgery was performed for removal of the object, which was later identified as cement (polymethyl methacrylate). Cement extravasation and embolism are well-known but rarely clinically significant complications after spinal surgery.