Age predicts long-term functional outcomes following vertebroplasty for osteoporotic vertebral compression fractures:...

Vertebroplasty provides effective pain relief for osteoporotic vertebral compression fractures; however, determinants of long-term functional recovery remain incompletely defined. This study aimed to evaluate baseline predictors of long-term patient-reported outcomes following vertebroplasty.

Ninety-two patients who underwent percutaneous vertebroplasty between 2010 and 2022 with complete patient-reported outcome measures (PROMs) at baseline, 6 months, and 2 years were included. The primary outcome was Short Form-36 (SF-36) Physical Function at 2 years. Multivariable linear regression models adjusted for baseline PROMs were used to evaluate associations with age, sex, vertebral region, and number of treated levels.

Mean age was 76.5±8.4 years, and 82.6% were female. Significant improvements were observed in Oswestry Disability Index (ODI) scores (77.3 to 25.3), SF-36 Physical Function (9.2 to 41.8), and visual analogue scale (VAS) back pain scores (8.0 to 1.7) at 2 years (all P<0.001). Increasing age was independently associated with poorer 2-year SF-36 Physical Function [β=-17.45 per 10-year increase; 95% confidence interval (CI): -24.43 to -10.47; P<0.001]. Procedural variables were not associated with postoperative outcomes. Baseline physical function demonstrated moderate correlation with postoperative outcomes (r=0.40-0.44) but was not independently predictive after adjustment.

Vertebroplasty was associated with sustained improvement in pain and function. Increasing age was the strongest observed independent predictor of poorer long-term physical function within this cohort, whereas procedural variables were not significantly associated with postoperative outcomes. These findings suggest that long-term functional recovery following vertebroplasty may be associated more strongly with patient-related than procedural factors within this cohort.