Previous studies have shown that vertebroplasty using PMMA is a safe and effective treatment for vertebral compression fractures. This case shows that spontaneous bursting fracture can develop even after cement augmentation. In summary, proposed etiologies of this phenomenon are ① insufficient interdigitation of bone cement due to high viscosity, ② inflammation of foreign body reaction, ③ interfered bone remodeling, and ④ thermal necrosis. New filler materials which have similar mechanical characteristics compared with bone and are not causing inflammation, foreign body reaction, not generating excessive heat are needed for more successful outcome in vertebroplasty.