Sagittal Alignment Following the Kyphoplasty of Acute Versus Chronic Osteoporotic Vertebral Compression Fracture

As a minimally invasive operation, kyphoplasty has become popular in the treatment of osteoporotic vertebral compression fracture (OVCF).

This study aimed to evaluate how the timing of kyphoplasty affects the parameters of sagittal alignment in OVCF.

In this prospective study, the patients with OVCF, who underwent kyphoplasty at our center, were recruited. Pre- and post-operative vertebral height, local and total kyphosis, coronal axis, sagittal vertebral axis, pelvic tilt, lumbar lordosis, sacral slope, and spino-cranial angle were evaluated and compared between acute OVCF (kyphoplasty performed within 1 month after injury) and chronic OVCF (kyphoplasty performed after 1 month from injury) patients.‎

Kyphoplasty was done for 18 acute and 28 chronic OVCF patients. All of the evaluated parameters, except spino-cranial angle, were significantly improved after the kyphoplasty. A significant difference was observed between the mean lumbar lordosis improvement of the two groups (P=0.026). In particular, the Mean±SD lumbar lordosis improved 6.1±6.6º in the acute patients and 0.92±7.86º in the chronic group. No other significant difference was observed between the improvement of the spinopelvic parameters in the two groups.

The timing of kyphoplasty impacts the improvement of spinopelvic parameters, ‎as well as the reduction of pain and restoration of vertebral height.