Progressive, repeated lumbar compression fracture at the same level after vertebral kyphoplasty with calcium phosphate cement

Abstract

The authors report a case of vertebral body collapse after kyphoplasty in which calcium phosphate cement (CPC) was used. The patient, a 69-year-old woman in whom an L-1 compression fracture had been revealed on magnetic resonance imaging, had been treated at another regional hospital for the compressed vertebra. Kyphoplasty in which CPC was used had been performed at that time. Two months later, she suffered from severe upper back pain, which was the same as the previously existing pain, and she experienced progressive weakness of both lower extremities (motor strength Grade 4/5). A more severe compression of the L-1 vertebra was revealed, and thecal sac compression caused by retrobulging of the CPC on the collapsed L-1 vertebra was present 5 months posttreatment. The authors performed decompression and fusion surgery to treat the repeatedly collapsed L-1 vertebra. They suggest that the use of CPC in vertebrae with compression fractures should be reconsidered.