Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2013 May;22 Suppl 3(Suppl 3):S341-5.
doi: 10.1007/s00586-012-2414-9. Epub 2012 Jul 3.

Instability of treated vertebrae after balloon kyphoplasty causing paraparesis in osteoporotic vertebral compression fracture: a report of two cases

Tetsuro Ohba  1 , Shigeto Ebata, Devin Clinton, Kenske Koyama, Hirotaka Haro
Affiliations
Case Reports

Instability of treated vertebrae after balloon kyphoplasty causing paraparesis in osteoporotic vertebral compression fracture: a report of two cases

Tetsuro Ohba et al. Eur Spine J. 2013 May.

Abstract

Purpose: To describe two unique cases of osteoporotic vertebral compression fracture (OVCF) treated with balloon kyphoplasty (BKP) that were complicated by spinal instability and resultant lower extremity paraparesis.

Methods: Kyphoplasty was performed in two patients with OVCF that had persistent back pain despite a course of conservative care. Immediately following BKP, both patients had a marked improvement in back pain. However, they developed progressive bilateral lower extremity weakness. Lateral spine flexion-extension radiographs demonstrated instability, and polymethyl methacrylate did not adhere to the endplate of the treated vertebrae.

Results: Both the patients underwent a hybrid fixation without a decompression. Postoperatively, both of them demonstrated gradual improvement in their neurological exam.

Conclusions: To the best of our knowledge, this is the first report describing the development of spinal instability with resultant delayed paraplegia following BKP. This case report demonstrates another cause of neurological decline following BKP, in the absence of cement leakage.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
(Case 1) a Sagittal T1- and T2-weighted images showing collapsed vertebral body with formation of a cavitary lesion at the L1 level. b Radiograph of the spine after BKP reveals effective filling of cystic fracture cavity
Fig. 2
Fig. 2
(Case 1) a Lateral spine flexion–extension radiographs demonstrated instability, and PMMA did not adhere to the endplate of the treated vertebrae. b Surgical intervention was performed by pedicle screw and hook fixation from Th10 to L2
Fig. 3
Fig. 3
(Case 2) a Sagittal T1-andT2-weighted images showing collapsed vertebral body with formation of a cavitary lesion at the L1 level. b Radiograph of the spine after BKP reveals effective filling of cystic fracture cavity
Fig. 4
Fig. 4
(Case 2) a Lateral spine flexion–extension radiographs demonstrated instability, and PMMA did not adhere to the endplate of the treated vertebrae. b Surgical intervention was performed by pedicle screw and hook fixation from Th10 to L2
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Borgstrom F, Zethraeus N, Johnell O, Lidgren L, Ponzer S, Svensson O, Abdon P, Ornstein E, Lunsjo K, Thorngren KG, Sernbo I, Rehnberg C, Jonsson B. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int. 2006;17:637–650. doi: 10.1007/s00198-005-0015-8. - DOI - PubMed
    1. Lieberman IH, Dudeney S, Reinhardt MK, Bell G. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 2001;26:1631–1638. doi: 10.1097/00007632-200107150-00026. - DOI - PubMed
    1. Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine (Phila Pa 1976) 2001;26:1511–1515. doi: 10.1097/00007632-200107150-00002. - DOI - PubMed
    1. Boonen S, Van Meirhaeghe J, Bastian L, Cummings SR, Ranstam J, Tillman JB, Eastell R, Talmadge K, Wardlaw D. Balloon kyphoplasty for the treatment of acute vertebral compression fractures: 2-year results from a randomized trial. J Bone Miner Res. 2011;26:1627–1637. doi: 10.1002/jbmr.364. - DOI - PubMed
    1. Phillips FM, Todd Wetzel F, Lieberman I, Campbell-Hupp M. An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine (Phila Pa 1976) 2002;27:2178–2179. doi: 10.1097/00007632-200210010-00019. - DOI - PubMed

Publication types