Percutaneous vertebroplasty (PVP) is a established minimally invasive technique for treating osteoporotic vertebral compression fractures, offering advantages such as minimal trauma and rapid recovery. However, delayed postoperative infection, though rare (incidence 0.1% - 2.5% ), remains a significant clinical challenge due to its insidious symptoms and the diagnostic interference caused by bone cement artifacts, which often lead to misdiagnosis as nonunion or spinal tumors. While antibiotic-loaded bone cement (ABC) is widely used to prevent implant-related infections, "breakthrough infections" have emerged as a new clinical hurdle . We report a case of a 76-year-old female with type 2 diabetes who developed a delayed Staphylococcus epidermidis infection 6 months post-PVP, in which antibiotic-loaded bone cement was not used. Initial infectious signs were missed, leading to disease progression. Diagnosis was confirmed through MRI, vertebral puncture biopsy, and bacterial culture. A comprehensive strategy comprising surgical debridement, 0.35% povidone-iodine irrigation, sequential sensitive antibiotic therapy (intravenous vancomycin followed by oral moxifloxacin for 6 weeks), anti-osteoporosis treatment, and standardized blood glucose management led to significant pain relief (VAS score decreased from 8 to 2 at 4 weeks postoperatively), normalization of inflammatory markers (ESR, CRP), and no recurrence at the 3-month follow-up. Drawing on relevant literature, this article systematically discusses the clinical features and key differential diagnoses of delayed PVP infection caused by S. epidermidis. We specifically analyze the prophylactic value of ABC, the mechanisms of "breakthrough infections," and the efficacy of our combined treatment strategy, aiming to enhance clinical awareness and improve management of this condition.

Youwei Cheng, Jinquan Long, Shen Tong, Jianyu Zou, Guowei Zhang. Delayed Staphylococcus Epidermidis Infection Presenting as Chronic Low Back Pain after Percutaneous Vertebroplasty: A Case Report and Literature Review. Academic Journal of Medicine & Health Sciences (2026), Vol. 7, Issue 2: 66-72. https://doi.org/10.25236/AJMHS.2026.070209.

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