Late Pyogenic Spondylitis after Vertebroplasty with PMMA-filled Adjacent Segments: A Case Report

ABSTRACT

OBJECTIVES: To report a rare case of late pyogenic spondylitis around the cement mass in T12 that developed 4 years after vertebroplasty with L1-3 bodies already filled with cement due to previous vertebroplasty. SUMMARY OF LITERATURE REVIEW: Pyogenic spondylitis after vertebroplasty is a rare complication, but very difficult to manage. MATERIALS AND METHODS: A 56-year old female visited us with pyogenic spondylitis around the T12 body. The bodies of L1-L3 had been filled with cement eight years previously, followed by another vertebroplasty for T12 four years previously in a local clinic. At first, conservative management with intravenous antibiotics was attempted for 8 weeks, without clinical improvement. Therefore, anterior surgery for T12 corpectomy, removal of the cement, and fusion was performed. RESULTS: The infection was cured and anterior fusion was achieved, and the patient was able to return to her previous activities. CONCLUSIONS: Though previous vertebroplasty of the adjacent vertebral body seemed to be a major obstacle to achieving fusion, anterior surgical treatment was the ultimate solution to this complex problem.