Endplate Resorption Accompanied by Bone Cement Fragmentation and Displacement in a 3-Year Follow-up after Osteoporotic Vertebral Compression Fracture Surgery

Abstract

Objective: To report a case of vertebral endplate cracks, gradual absorption, and eventual stress-induced bone cement fracture and displacement following minimally invasive vertebroplasty in a patient with osteoporotic vertebral compression fractures confirmed through imaging follow-up. Methods: A retrospective study was conducted by reviewing the same patient from 2022 to 2025 at Daozhen County Traditional Chinese Medicine Hospital, Guizhou Province. Clinical and imaging data were analyzed for an elderly patient with osteoporotic fractures after surgery, which included X-ray, CT, and MRI showing disappearance of the affected vertebral endplates and pseudoarthrosis formation. The 63-year-old female patient suffered an injury leading to outpatient MRI revealing T12 vertebral damage, compression in T6, T8, L1-4 vertebrae, and local inflammatory changes in L4 and L5. Two-year postoperative follow-up showed disappearance of the upper endplate of the affected vertebra and the lower endplate of the adjacent vertebra along with pseudoarthrosis formation. Results: Imaging showed endplate cracks and fractures in vertebral bodies after minimally invasive osteoporotic compression fracture surgery, with stress leading to endplate absorption and bone cement fracture and displacement. Conclusion: Postoperative endplate cracks, fractures, absorption, and eventual bone cement fracture and displacement following vertebroplasty in osteoporotic vertebral compression fractures are strongly associated with osteoporosis, vertebral stress, and physical activity.