Introduction

As the population ages, the number of osteoporotic vertebral fractures (OVF) is increasing. Delayed union, non-union, pseudoarthrosis could be occurred when the diagnosis for VCFs delays or its treatment did not work. The effects of early diagnosis of OVF and its treatment by balloon kyphoplasty (BKP) were examined.

Methods

A total of 118 patients who were diagnosed with OVF and underwent BKP were analyzed. After their OVF diagnosis was confirmed, patients were placed in a brace and hospitalized for BKP. Numerical rating scale (NRS) at 3 months post-BKP, radiological subsequent fracture (SF) at adjacent level, painful SF at adjacent level, correction angle and correction loss were used as the objective variables for Fisher's exact test. The time taken to confirm the diagnosis (within 7 days; early diagnosis group vs. after 7 days of injury; late diagnosis group) and the timing of BKP (within 28 days; early BKP group vs. after 28 days of OVF diagnosis; late BKP group) were used as explanatory variables, respectively, and a multivariate logistic regression analysis of the objective variables was performed after adjusting for sex, age, bone material density, and affected vertebrae level.

Results

The study participants comprised 26 men and 92 women with a mean age of 80.8 years. Patients who had their diagnosis of OVF confirmed in early diagnosis group had significantly lower NRS scores at 3 months than those who had their diagnosis confirmed in late diagnosis group (0.62 vs. 1.46, p < 0.05). Likewise, radiological SF was also significantly lower in those who had their diagnosis of OVF confirmed in early diagnosis group as opposed to those who had their diagnosis confirmed in late diagnosis group (11.8% vs. 34.0%, p < 0.005). The percentage of radiological SF at 3 months was significantly lower in early BKP group than in late BKP group. (12.5% vs. 39.5%, p < 0.005). Furthermore, although not significant in the early diagnosis group and the late diagnosis group, the correction angle was larger in the late diagnosis group (6.0 ° vs 6.6 °, p = 0.57). On the other hand, the late BKP group had a significantly larger correction angle than the early BKP group (5.4 ° vs 8.0 °, p <0.05). In multivariate analysis, radiological SF was significantly higher in those who had their OVF diagnosis confirmed in late diagnosis group (odds ratio, 3.4; 95% CI, 1.06–10.9; p < 0.05). Furthermore, radiological SF was also significantly higher in late BKP group (odds ratio, 3.9; 95% CI, 1.2–12.8; p < 0.05).

Discussion

Our results revealed that radiological SF significantly increased in patients who had their diagnosis of OVF confirmed after 7 days of injury and in those who underwent BKP after 28 days of OVF diagnosis.