Premature bone cement displacement leading to adjacent vertebra fracture following percutaneous kyphoplasty in Kümmell's disease: a case report and literature review

Heng Wu ¹ Hairui Li ² Hao Chi ³ Shuang Xu ¹ Song Wang ^1*

• ¹ Department of Orthopedics, the Affiliated Hospital of Southwest Medical University Luzhou 646000, China, Luzhou, China
• ² Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
• ³ Clinical Medical College, Southwest Medical University, Luzhou 646000, China, Luzhou, Sichuan Province, China

In recent years, the advancement of minimally invasive treatments has led to a rapid increase in the application of percutaneous kyphoplasty for the management of Kümmell's disease. However, bone cement displacement, although relatively rare, can have catastrophic consequences.Case: Here, we represent a unique case of premature bone cement displacement leading to adjacent vertebra fracture, alongside a literature review regarding its causes and management. An 80-year-old male diagnosed with thoracolumbar 10 Kümmell's disease underwent percutaneous kyphoplasty. Unfortunately, the patient experienced recurrent back pain three days post-surgery. Subsequent X-ray and MRI showed a blocky distribution of bone cement that poorly interlocked with the surrounding cancellous bone at thoracolumbar 10, leading to its displacement and resulting in a fracture of thoracolumbar 9. Given the poor tolerance for open surgery, we revised it successfully through repeated cement sequential infusion technique. Postoperatively, the patient reported significant pain relief. During one-year follow-up, the patient achieved continued pain relief and functional improvement, with three-dimensional CT exhibiting effective cement anchoring.Premature bone cement displacement leading to adjacent vertebra fractures is a rare complication that is often overlooked by clinicians. The implementation of the cement sequential infusion technique presents a novel approach to treatment, potentially reducing the need for open surgical interventions.