Compression Rate Progression of Osteoporotic Vertebral Compression Fracture in Conservative Treatments

The treatment of osteoporotic vertebral compression fracture (OVCF) aims to alleviate pain and prevent further compression; however, compression often progresses during conservative treatments. Furthermore, studies on the factors affecting compression rate progression and the timing at which compression progresses the most are limited.

A total of 122 patients with OVCF, who were follow-up duration > 6 months, were included. Factors, such as age, sex, fracture levels, bone mineral density, body mass index, medications for osteoporosis, initial compression rate, fracture locations, and pelvic incidence were assessed. The compression rates were measured initially and at 1, 2, 3, and 6 months. The correlation between these factors and compression rate progression of > 50% was analyzed using univariate and multivariate Cox regression analyses. The compression rate progression over time was evaluated using a repeated-measures general linear model, and clinical outcomes were assessed using a paired t-test.

Univariate analysis showed that an initial compression rate of < 30% was significantly associated with progression (P = 0.001). Multivariate Cox regression confirmed this association (P = 0.013; hazard ratio, 3.018; 95% confidence interval, 1.265-7.200). The most significant compression rate progression occurred within the first month of follow-up (P = 0.038). At the final follow-up, the visual analog scale for back pain (P = 0.009) and Oswestry Disability Index (P = 0.026) were significantly higher in the compression rate progression group.

An initial compression rate of < 30% was highly correlated with compression rate progression, particularly within the first month after injury. Compression rate progression correlated with clinical outcomes in terms of pain and quality of life.