Abstract
Background and Aim Numerous studies have been conducted regarding vertebral restoration, development
of kyphotic deformity, and pain control following balloon kyphoplasty. However, there
is no consensus regarding the ideal time to perform kyphoplasty. Herein, we aimed
to compare the results of treatment of different vertebral levels following early
or late kyphoplasty.
Patients and Methods Between 2017 and 2022, 283 patients with single-level osteoporotic vertebral fractures
were retrospectively reviewed. Patients in whom visual analog scale (VAS) values were
recorded, and osteoporosis tests performed were included in the study. Traumatic single-level
fractures in patients with osteoporosis who were aged > 60 years were included. Patients
with a history of malignancy, previous spinal surgery, or neurological deficits were
excluded. A total of 100 patients met the inclusion criteria. A total of 50 patients
underwent kyphoplasty within 3 days of sustaining the fracture (Group 1), and 50 patients
underwent kyphoplasty more than 3 days after sustaining the fracture (Group 2). Groups
A, B, and C included fractures at the T7–T11 levels, T12–L1 levels (thoracolumbar
junction), and L2–L5 levels, respectively. These groups were compared among themselves.
Bilateral balloon kyphoplasty was performed under sedation in the prone position.
Preoperative and postoperative VAS scores, anterior vertebral heights, and kyphotic
angles (KAs) were measured and recorded. The vertebral segments that underwent early
and late kyphoplasty were also compared among themselves.
Results In all the patients who underwent early or late kyphoplasty, there was a significant
decrease in the KA and a significant increase in vertebral heights during the early
postoperative period (p < 0.001). There was no significant change in the vertebral heights and KA between
the early and late postoperative periods (p = 0.780). Early kyphoplasty demonstrated better pain control with a greater improvement
in VAS score (p < 0.001) than late kyphoplasty.
Conclusion Kyphoplasty plays an important role in reducing pain and ensuring early mobilization
in older patients. In our study, the improvements in both symptoms and radiological
features are concrete evidence in favor of performing early kyphoplasty.
Keywords
early mobilization - kyphotic deformity - prone position - vertebral restoration
