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). Objectives: This study aimed to evaluate how the timing of kyphoplasty affects the parameters of sagittal alignment in OVCF. Methods: 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. Results: 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. Conclusion: The timing of kyphoplasty impacts the improvement of spinopelvic parameters, as well as the reduction of pain and restoration of vertebral height