A study on the factors influencing the improvement of spinal kyphosis after percutaneous vertebroplasty for thoracolumbar compression fractures in the elderly

This study aims to evaluate the efficacy of percutaneous vertebroplasty in treating compression fractures of the thoracolumbar spine in elderly patients and to analyze factors influencing the improvement of postoperative kyphotic deformity. A retrospective review was conducted of 106 patients treated with percutaneous cement injection at our hospital from January to December 2024. Preoperative and 3-month postoperative measurements included anterior/mid-height ratio of the injured vertebra, wedge angle, and Visual Analogue Scale. Patients were categorized into an improvement group (n = 79) and a non-improvement group (n = 27) based on a wedge angle difference >3.0°. All procedures were completed successfully. At 3 months postoperatively, vertebral height increased compared to preoperative levels, while wedge angle and Visual Analogue Scale decreased (all P < .05). No statistically significant differences existed between groups in gender, time from fracture to surgery, or operative duration (P > .05). Significant differences were observed in postoperative hospitalization duration, bone mineral density, bone cement leakage, and age (P < .05). Spearman analysis revealed correlations between wedge angle change and these factors; logistic regression identified reduced bone mineral density, cement leakage, prolonged postoperative hospitalization, and advanced age as independent risk factors (all P < .05). Percutaneous vertebroplasty restores vertebral height, stabilizes the spine, and provides pain relief, but its kyphosis correction is limited. Factors such as low bone mineral density, leakage, postoperative hospitalization duration, and age warrant attention through targeted interventions to optimize outcomes.