Infection Following Vertebroplasty or Kyphoplasty: A Systematic Review of Risk Factors, Treatment Options and Outcomes

Study DesignSystematic Review.ObjectivesInfection following vertebral augmentation using Percutaneous vertebroplasty (PV) and percutaneous balloon kyphoplasty (PBK) is an exceedingly rare, but potentially life-threatening complication. This systematic review evaluates the microbiological characteristics, risk factors, treatment strategies and outcomes of these infections.MethodsPubMed, Scopus, and Mendeley databases (2000-2025) were systematically reviewed. Inclusion criteria involved case cohorts of more than 5 adult patients with infections following PV or PBK. Data on the initial procedure, demographics, infection biomarkers, neurologic status, comorbidities, causative pathogens, treatment protocols, and outcomes were evaluated.ResultsA total of 102 patients from 8 studies were included (mean follow-up: 22.9 months). Most were female (64.7%) with a mean age of 71.0 years (range: 50-95). The mean time interval from the initial procedure to infection diagnosis was 5.2 months (range: 0.03-85.2). The most common pathogen was <i>Mycobacterium tuberculosis</i> (35.3%). The mean infection biomarkers were CRP 36.77 mg/dL (range: 0.05-343), ESR 56.98 mm/h (range: 6-126), and WBC 8.53 cells/mm³ (range: 2.09-22.35). Seven patients (6.1%) were treated conservatively, while 95 patients (93.1%) underwent revision surgery. Outcomes were reported for 89 patients (87%). Final follow-up showed that 34 patients (38%) achieved normal mobility, 22 patients (25%) had assisted mobility (crutches or walker), and 11 patients (12%) required a wheelchair. The mobility status was unclear for 11 patients (12%). The mortality rate was 12.3%. Post-treatment mobility was strongly dependent on preoperative neurologic status (OR = 6.0, <i>P</i> = 0.001).ConclusionsPost-augmentation spinal infections are rare but serious. Outcomes are strongly influenced by preoperative neurological status, while pathogen type and patient comorbidities have limited prognostic impact.