Intraoperative Suction-Assisted Kyphoplasty for Immediate Removal of Posterior PMMA Extravasation in Decompressed Vertebral Compression Fractures

<b>Background:</b> Vertebral compression fractures are prevalent in elderly patients with osteoporosis. While the vertebral augmentation procedure is often used for symptom control and improving life quality, cement leakage is still a significant complication of vertebral augmentation procedures. This case report describes a 92-year-old man with a T8 compression fracture who underwent kyphoplasty with low-viscosity bone cement after failed conservative treatment. <b>Methods:</b> A previously developed decompressed kyphoplasty technique using dual portals was employed to reduce intravertebral pressure; however, fluoroscopy revealed posterior leakage toward the spinal canal. A case-specific intraoperative modification of this established technique was then applied, converting the injection portal into a suction channel to aspirate extravasated cement before it hardened. <b>Results:</b> This approach averted spinal cord compromise, obviated the need for additional decompression surgery, and preserved neurological function. The patient achieved rapid pain relief and early mobilization. <b>Conclusions:</b> This case demonstrates how a suction-assisted intraoperative maneuver may be used to manage posterior cement leakage during decompressed kyphoplasty.