A 79-year-old diabetic woman with a fresh T9 osteoporotic compression fracture, underwent percutaneous kyphoplasty using polymethyl methacrylate. About 2.5 months after the operation, the patient was readmitted because of increasing back pain, nocturnal sweating and subfebrile temperature. The diagnosis of pyogenic spondylitis was made using radiograph and magnetic resonance imaging. The patient was successfully treated with antibiotics for 2 month. Only five cases of infections after kyphoplasty have been described so far. Our case is probably the first post kyphoplasty spondylitis which was treated non-operatively.For the kyphoplasty patients with diabetes and older age, specific modifications to prophylactic antibiotic protocols such as using higher doses of cefazolin or broad-spectrum antibiotics should be considered.