Cement fragmentation and delayed vertebral collapse following percutaneous vertebroplasty: A rare case report and surgical management

Abstract

Study Design: Case report. Purpose: To describe a rare complication of percutaneous vertebroplasty [PVP], cement fragmentation with delayed vertebral collapse, managed surgically with combined reconstruction.Case Presentation: An 82-year-old woman with comorbidities underwent vertebroplasty for a fracture, achieving pain relief and mobility. Later, she had severe pain and neurological deficits. Radiology showed L2 collapse, PMMA cement fragmentation, and spinal compression. Tests excluded infection and malignancy.Management and Outcome: A staged surgical approach was used. Stage one involved anterior debridement, L2 corpectomy, decompression, and fusion. Stage two involved posterior stabilisation. Histopathology showed fibrous tissue and cement fragments without infection or malignancy. Postoperatively, the patient had pain relief, neurological improvement, and regained mobility.Conclusions: Cement fragmentation with delayed collapse after PVP can cause instability and neurological deficits. Risk factors include osteoporosis and steroid use. Prompt reconstruction can restore stability and improve quality of life. Careful patient selection, technique, and osteoporosis management are essential to minimise complications.