Effects of percutaneous kyphoplasty with concomitant postural reduction in the treatment of acute osteoporotic vertebral compression fractures

Abstract

Objective To investigate the effects of postural reduction during balloon expansion in percutaneous kyphoplasty (PKP) for patients with acute osteoporotic vertebral compression fractures (OVCF). Methods From January 2022 to December 2023, 75 patients with acute OVCF underwent PKP surgery at our institution and were followed up for at least 12 months. Patients were divided into Group A and Group B based on whether they underwent postural reduction during balloon expansion. Clinical evaluation included Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores for back pain; Radiographic evaluation included lumbar lordosis angle (LL), anterior vertebral height (AVH) and rate (AVHr). Results There were no significant differences in baseline clinical and radiographic parameters between the two groups (P > 0.05). Both groups showed significant improvement in VAS, ODI, and LL at one day, one month, and final follow-up post-surgery compared to preoperative levels (P < 0.05). Group A exhibited significantly greater improvements in ODI, LL, AVH, and AVHr at the final follow-up compared to Group B (P < 0.05). Regarding complications, including cement leakage, adjacent segment fractures and refracture of the treated vertebral body, there was no statistically significant difference between Group A and Group B (P > 0.05). No significant between-group differences were observed in the recorded complications. Patients who developed adjacent vertebral fractures or treated-vertebra recollapse were managed nonoperatively, and none required reoperation during follow-up. Conclusion PKP combined with postural reduction during balloon expansion is an effective treatment for acute OVCF, as it can further restore vertebral height, and regional lumbar alignment. Hence, it is recommended for clinical application in suitable patients.