Tetsuro Ohba, Shigeto Ebata, Devin Clinton, Kenske Koyama, Hirotaka Haro


July 2012, Volume 22, Issue 3, pp 341 - 345 Case Report Read Full Article 10.1007/s00586-012-2414-9

First Online: 03 July 2012

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.


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