Heterotopic ossifications after vertebroplasty using calcium phosphate in osteoporotic vertebral compression fractures:

Abstract 

Background

Recently, calcium phosphate (CaP) cement, instead of polymethylmethacrylate, has been injected into the compressed vertebral body. Calcium phosphate may have the potential for ectopic or heterotopic ossification and, thus, injected CaP cement can induce unwanted heterotopic ossifications in the human body.

Case Description

The authors describe 2 cases of heterotopic ossifications after vertebroplasty using CaP in osteoporotic vertebral compression fractures. We performed percutaneous vertebroplasty using CaP cement in a 69-year-old woman with L2 compression fracture and an 80-year-old man with L1 compression fracture. Follow-up radiologic studies for both cases showed that heterotopic ossifications had developed around the CaP-augmented vertebral bodies and that the cemented vertebral bodies had recollapsed. Also, subsequent vertebral compression fractures had occurred.

Conclusions

We suggest that heterotopic ossification may be complications of vertebroplasty with CaP. Therefore, we strongly recommended that the patients who undergo a vertebroplasty with CaP need strict observation.

Abbreviations: CT, computed tomography, MR, magnetic resonance.

Keywords: Calcium phosphate, Vertebroplasty, Heterotopic ossification