Vertebroplasty of compression fracture with prevertebral hematoma during treatment of postherpetic neuralgia: A case report

ABSTRACT

Postherpetic neuralgia (PHN) and vertebral compression fracture (VCF) are common causes of chronic pain in the elderly population. Careful history taking and imaging studies are needed for diagnosis when both diseases coexist. Vertebroplasty is a clinically efficient surgical treatment of VCF, while nerve block and/or medications are the mainstay of PHN pain control. The most serious complications of vertebroplasty are pulmonary embolism or neurologic deficit due to cement leakage. An 80-year-old female patient was diagnosed with PHN of the right L1 dermatome; however, her pain expanded to the midback and subcostal area. Thoracic magnetic resonance imaging and abdominal computed tomography revealed recent L2 compression fracture with prevertebral hematoma caused by cortical bone defect of the L2 body. Even though the risk of cement leakage was high, L2 vertebral body augmentation was performed using a bone filler device and high-viscosity cement; this treatment was successful, without cement leakage or any other complications.