An orthopedic surgery expert witness opines on a case where a patient was left with chronic pain as a result of cement extravasion following a kyphoplasty. This case involves a fifty-one-year-old female patient with a past medical history of hypertension, hyperthyroidism and back pain. The patient presented to her primary care physician complaining of worsening back pain. The physician initially managed the patient’s condition with conservative treatment and non-steroidal anti-inflammatory drugs for pain relief. When conservative management proved ineffective and the back pain continued to worsen the primary care physician referred the patient to an orthopedic surgeon for further evaluation. She was seen shortly thereafter by the surgeon. He ordered a CT scan of the patient’s spine. The scan revealed extensive lytic expansile lesions in the transverse and spinous processes of vertebral bodies of L3, 4, 5, as well as in the posterior elements of L2 and L1. A pathologist was consulted who diagnosed the patient with fibrous dysplasia and the treating orthopedic surgeon performed a subsequent kyphoplasty. The surgery appeared to go well with no complications during the procedure. However, in the immediate post-operative period she complained of severe pain and her condition began to decline drastically. The patient was taken for an MRI which indicated that significant extravasated cement was present in the spinal canal. The patient was returned to the operating room by the treating physician the following day to remove the excess cement. The patient was left with severe pain in her left leg and numbness as a result of the original procedure.