# Epidural haematoma following vertebroplasty for osteoporosis compression fracture: A case report

## TL;DR

A 67-year-old woman developed an epidural haematoma after a vertebroplasty procedure for an osteoporotic fracture, highlighting the rare but serious risks of the treatment.

## Contribution

This case report emphasizes the risk of epidural haematoma following vertebroplasty and the importance of preoperative imaging to prevent complications.

## Key findings

- Epidural haematoma occurred after vertebroplasty due to puncture of the epidural venous plexus.
- Preoperative CT and MRI analysis can help reduce the risk of such complications.
- Urgent surgical decompression improved neurological symptoms in the patient.

## Abstract

Percutaneous vertebroplasty (PVP) is a minimally invasive procedure commonly used to alleviate pain and stabilise vertebral compression fractures caused by osteoporosis. Although generally safe, the procedure carries the risk of rare complications, such as epidural haematomas.

We present the case of a 67-year-old woman who underwent PVP for an abnormal pedicle structure associated with an osteoporotic compression fracture that led to the subsequently development of an epidural haematoma. The patient presented with severe back pain following a fall at home. Imaging revealed a T12 vertebral compression fracture with marked collapse and posterior wall involvement. The pain and functional impairment persisted despite conservative management. After polymethylmethacrylate injection into the fractured vertebrae, the patient reported unbearable lower back pain and bilateral lower limb weakness, which progressed to paraplegia.

Magnetic resonance imaging of the spine revealed bilateral epidural haematomas at T11–T12, causing significant spinal cord compression. Urgent surgical decompression was performed to relieve nerve compression. Neurological symptoms improved gradually.

This case highlights the importance of early diagnosis and management of the complications of PVP, including epidural haematoma.

•PVP involves the injection of a biomaterial to manage vertebral fractures.•Epidural haematoma may be caused by the puncture of the epidural venous plexus.•Preoperative CT and MRI analysis can reduce the risk of epidural haematoma after PVP.

PVP involves the injection of a biomaterial to manage vertebral fractures.

Epidural haematoma may be caused by the puncture of the epidural venous plexus.

Preoperative CT and MRI analysis can reduce the risk of epidural haematoma after PVP.