# Multilevel posterior spinal fusion following percutaneous third generation kyphoplasty complicated by vertebral compression fracture progression

## TL;DR

A patient with complications from third generation kyphoplasty was successfully treated with spinal fusion, providing long-term pain relief.

## Contribution

This case demonstrates the effectiveness of posterior pedicle spinal fusion in managing third generation kyphoplasty complications.

## Key findings

- PPSF corrected vertebral compression fracture progression and kyphosis.
- Symptomatic improvement was observed for back, thigh, and groin pain post-surgery.
- Long-term quality of life improved with sustained pain relief.

## Abstract

Newer third generation percutaneous kyphoplasty (PKs) may minimize risks associated with older generation kyphoplasties such as new adjacent fractures, fracture progression, cement leakage, neurologic sequelae, and kyphosis. Additionally, posterior pedicle spinal fusion (PPSF) may minimize risk of long-term complications following PKs while maximizing the benefits of stable spinal alignment. The patient developed adjacent fracture progression, posterior retropulsion, and kyphosis following third generation kyphoplasty. Vertebral compression fracture progression was corrected and prolonged symptomatic relief was successfully achieved with T11-L4 PPSF and L1-L2 laminectomy. Postoperative follow-ups at 2, 4, 7 weeks, 1 and 2 years showed continued symptomatic improvement in back pain with resolution of thigh and groin pain. This case supports the use of PPSF in third generation PK-related complications to provide long-term symptom relief and improve quality of life in patients with severe osteoporotic compression fractures.

Multilevel posterior pedicle spinal fusion to correct complications of refracture, posterior retropulsion, and kyphosis following third generation kyphoplasty.