Early Percutaneous Kyphoplasty Is Associated with Reduced Risk of Subsequent Thoracic Vertebral Compression Fracture.

Area of Science:

• Orthopedics
• Spinal Surgery
• Osteoporosis Management

Background:

• Osteoporotic vertebral compression fractures (VCFs) are common, and percutaneous kyphoplasty (PKP) is an effective treatment.
• Concerns exist regarding the risk of subsequent VCFs after PKP.
• Optimal timing for PKP to minimize subsequent VCF risk is not well-defined.

Purpose of the Study:

• Determine the optimal time interval between primary VCF and PKP to minimize 2-year subsequent VCF risk.
• Evaluate the impact of this optimal interval on 90-day medical complications.

Main Methods:

• Retrospective cohort analysis of 16,197 patients undergoing PKP for thoracic VCF (2010-2022).
• Stratum-specific likelihood ratio (SSLR) analysis to identify data-driven timing thresholds.
• Multivariable regression to control for confounders and assess complication rates.

Main Results:

• SSLR identified two timing strata: same-day PKP (0 weeks) and delayed PKP (1-30 weeks).
• Same-day PKP significantly reduced the risk of 2-year subsequent VCFs compared to delayed intervention (OR: 0.52; 95% CI: 0.47-0.56; p<0.001).
• Early PKP nearly halved the risk of subsequent VCFs.

Conclusions:

• Performing PKP on the same day as the primary VCF significantly lowers the risk of subsequent VCFs within two years.
• Prioritizing patient optimization during the preoperative period is crucial for balancing timely intervention and comprehensive evaluation.