Abstract
Introduction: Preventing subsequent vertebral fractures (SVFs) is a common challenge in surgical and conservative treatment for osteoporotic vertebral fractures.
This study examined whether continuation of multiple types of exercise after balloon kyphoplasty (BKP) can prevent SVF and progression of kyphosis.
Methods: Included were 130 patients who received a first BKP and had a 6- or 12-month follow-up assessment. All patients received postoperative treatment, including pharmacotherapy for osteoporosis, use of a thoracolumbar corset for ≥3 months, and had postoperative inpatient rehabilitation. Outpatient physical therapy consisted of strengthening, aerobic, and balance exercises, and was offered once or twice a week for 3 months to patients willing to continue rehabilitation (PT or control group). The primary outcome was the incidence of SVFs. Secondary outcomes were the incidence of falls, radiographic spinopelvic alignment, physical function (muscle strength and gait performance), and patient-reported outcomes on a numerical rating scale, Oswestry disability index, MOS 36-item short-form health survey, and EuroQol 5 dimension 5 level at baseline and 3, 6, and 12 months after BKP.
Results: Fifty and 80 patients were included in the PT and control groups, respectively. At baseline, only thoracic kyphosis differed between the groups (PT: 33.5° vs. control: 42.1°). The incidence of SVFs was lower in the PT group than in the control group at 3 months (2% vs. 14%) and at the final follow-up (4% vs. 19%). Trunk extensor muscle strength (4.1 kg vs. 0.4 kg) and the EuroQol 5 dimension 5 level at 3 months (0.38 vs. 0.23) and the Oswestry disability index at the final follow-up (−34.1 vs. −22.5) improved significantly from the baseline in the PT group compared with the control group.
Conclusions: Continued exercise, including back muscle-strengthening, aerobic, and balance exercises, seems to be effective for preventing SVF after BKP. The best means of keeping patients exercising after BKP is a challenge for future study.
