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Percutaneous vertebroplasty is often used to acquire the stability of the spine and relieve the pain caused by osteoporotic vertebral compressive fracture (OVCF). 125I seeds have been used for application of local therapy for tumors. A combined treatment was reported in previous literatures. Thus, this case report is aimed at reporting a patient with an occurrence of delayed radioactive myelopathy, who accepted percutaneous vertebroplasty combined with interstitial implantation of 125I seeds for metastatic spinal tumors, and at reviewing the published literatures.

Highlights Potential risk of impertinent adminstration of Methylprednisolone in lumbar spine surgery. The diagnosis of Addisonian crisis on perioperative duration in spine surgery when patient accepts intravenous Methylprednisolone. The management strategies of perioperative Addisonian crisis induced by postoperative routine cessation of intravenous Methylprednisolone.

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