Delayed L2 vertebrae split fracture following kyphoplasty.

Area of Science:

• Orthopedics
• Neurosurgery
• Radiology

Background:

• Osteoporotic vertebral compression fractures (OVCFs) are a common cause of pain and disability.
• Balloon kyphoplasty is a minimally invasive procedure to treat painful OVCFs.
• Reported complication rates for kyphoplasty in OVCFs range from 1% to 3%, typically occurring perioperatively.

Observation:

• A case is presented where balloon kyphoplasty was performed following manufacturer guidelines for an OVCF.
• Four weeks post-procedure, the patient developed a new, painful split vertebral fracture with anterior deformity at the previously treated level.
• This delayed complication occurred despite a seemingly successful initial kyphoplasty.

Findings:

• Delayed split vertebral fracture at the same level after successful balloon kyphoplasty is a potential complication.
• This specific complication was observed four weeks after the initial intervention.
• The fracture presented with anterior deformity and significant pain.

Implications:

• Clinicians should consider delayed, recurrent fractures at the kyphoplasty site in the differential diagnosis of new-onset pain.
• This case highlights the importance of long-term monitoring for patients undergoing kyphoplasty.
• Further research may be warranted to understand the mechanisms and risk factors for delayed fractures post-kyphoplasty.