Description:
Objective: With the aging population, the incidence of vertebral body fractures is also increasing, making their optimal treatment strategy a substantial medical challenge. The minimally invasive surgical procedure of kyphoplasty is an effective surgical treatment option for stable vertebral body fractures, which can achieve quick reduction of pain as well as height restoration of the affected vertebral body. However, the optimal timing of kyphoplasty has still been a matter of controversy. The aim of this study was therefore to investigate the relationship between the timing of kyphoplasty and the clinical as well as radiological outcome. Methods: This work is based on a retrospective cohort study. 230 patients who underwent kyphoplasty of a single vertebral body fracture between January 2012 and December 2018 were included. The patients were divided into an acute ( 6 weeks; n = 39) group, depending on the time interval between fracture occurrence and surgery. Clinical parameters such as pain progression according to the visual analogue scale and the need for pain medication as well as the radiological parameters vertebral body height, local kyphotic angle and sagittal alignment were compared pre- and postoperatively within and between the groups. Results: After balloon kyphoplasty there was a significant reduction of pain according to the visual analogue scale in all three groups (all groups: p < 0.001). The use of analgesics was significantly reduced in the acute and subacute groups until discharge though this effect could not be seen in the chronic group (acute: p = 0.001; subacute: p = 0.001; chronic: p = 0.642). This equally applied to the reduction of LKA (acute: p < 0.001; subacute: p < 0.001; chronic: p = 0.053). In all three groups, a significant postoperative improvement in anterior and middle vertebral body heights was achieved (all groups: p < 0.001). Patients of the subacute group showed a significantly better ...