Delayed Paraplegia after Successful Percutaneous Vertebroplasty in a Patient with Osteoporotic Compression Fracture: A Case Report

ABSTRACT

STUDY DESIGN: A case report. OBJECTIVES: We report a case of a female patient initially diagnosed as osteoporotic vertebral fracture without any noticeable injuries to posterior ligament complex, who later developed with incomplete paraplegia resulting from an unrecognized trauma after vertebroplasty. SUMMARY OF LITERATURE REVIEW: Vertebroplasty remains a safe and effective procedure for osteoporotic vertebral fracture. However, there have been many reports regarding neural injury associated with cement leakage. MATERIALS AND METHODS: An 81-year old woman with a sudden motor weakness and a sensory loss on her lower extremities after an unrecognized trauma was admitted to our clinic. She had undergone a vertebroplasty twelve days before the admission. At the time of vertebroplasty, Magnetic resonance (MR) imaging showed a compression fracture at T10 vertebra without any posterior ligament complex (PLC) injury. Follow up MR imaging was taken 12 days after vertebroplasty, and it revealed posterior shift of T10 body with a fracture of spinous process, tear of left facet joint capsule, partial tear of interspinous ligament of T10-11 with retrolisthesis, and narrowing of spinal canal at T10-11 by T11 lamina. RESULTS: Immediate surgical treatment was performed to decompress the neural structures, and to stabilize the spinal column. However, neurological recovery was unsatisfactory. CONCLUSIONS: Spinal surgeons should be aware of the possibility of the development of any neurologic deterioration, even if successful vertebroplasty is performed.