Successful Treatment of Secondary L5 Osteoporotic Vertebral Fracture Post-balloon Kyphoplasty With Revision Balloon Kyphoplasty

Balloon kyphoplasty (BKP) is a standardized, minimally invasive procedure for treating osteoporotic vertebral fractures. However, secondary osteoporotic vertebral fractures following BKP are uncommon in clinical practice, and there is limited published experience with revision BKP for this condition. An 82-year-old man presented to our clinic with back pain after a fall. Computed tomography and magnetic resonance imaging revealed an osteoporotic L5 vertebral fracture. As conservative treatment was unsuccessful, he underwent BKP for the L5 fracture, which alleviated his pain. Twenty days post-operatively, the patient developed renewed back pain. Subsequent imaging demonstrated a secondary osteoporotic fracture within the previously treated L5 vertebra, involving both the upper and lower endplates. While posterior fixation was considered, the patient declined surgery. Therefore, we performed a revision BKP to address the secondary fracture. The postoperative course was uneventful, and 10 months later, computed tomography images showed evidence of bone healing and remodeling in the L5 vertebral body. Our case suggests that revision BKP may be an effective treatment option for secondary osteoporotic vertebral fractures. However, careful patient selection is crucial to ensure the safety and efficacy of this procedure.