Efficacy and safety of balloon kyphoplasty for osteoporotic vertebral fractures in older adult patients older than 90 years old

Abstract

Introduction: Comorbidities are common in older adult patients, especially those >90 years of age, and the development of complications and decline in activities of daily living (ADL) are problems in the treatment of osteoporotic vertebral fractures (OVF). Balloon kyphoplasty (BKP) for OVF is a minimally invasive and effective treatment for immediate pain relief and early ADL recovery. We investigated whether BKP is efficacious and safe in older adult patients >90 years.

Methods: The participants were patients aged ≥90 years who were diagnosed with OVF and underwent BKP between January 2018 and November 2021, divided into 20 cases performed within 14 days after injury (very early group) and 15 cases performed after 15 days after injury (standby group). The study items were the numerical rating scale (NRS) for back pain during physical activity before and after surgery, the rate of decline in ADL, and the presence or absence of complications during hospitalisation.

Results: The preoperative and postoperative NRS improved significantly in both groups, with the very early group improving from an average of 6.9 to 3.4 and the standby group improving from 6.5 to 2.5. However, there was no significant difference between the two groups in terms of preoperative and postoperative NRS (see above), ADL decline rate (very early group: standby group = 50%:46.7%), or inpatient complications (10%:6.7%) between the two groups.

Conclusions: BKP for OVF in very older adult patients can be performed without conservative treatment if the pain persists after bed rest and ADL impairment are evident, even if it is not very early.