Impact of Percutaneous Vertebroplasty on Vertebral Height and Sagittal Alignment in Thoracolumbar Osteoporotic Compression Fractures: A Retrospective Observational Study

Purpose: This study aimed to evaluate whether percutaneous vertebroplasty (PVP) contributes to vertebral height restoration and sagittal alignment correction in osteoporotic vertebral compression fractures (OVCF), focusing on thoracolumbar junction fractures.Methods: A retrospective review of 40 patients with single-level OVCF at T10–L2 treated with PVP was performed. Vertebral heights (anterior, middle, and posterior) and sagittal alignment (thoracic kyphosis, lumbar lordosis, sagittal vertical axis, and segmental Cobb's angle) were measured preoperatively, at 3 months, and at 6 months. Clinical outcomes included visual analog scale and EuroQol-5 Dimensions.Results: Significant pain relief and improvement in quality of life were observed at 6 months postoperatively. Vertebral height restoration, particularly in the anterior and middle portions, was noted at 3 months; however, partial loss of the restored height occurred by 6 months. Most sagittal alignment parameters showed no significant postoperative change, although lumbar lordosis significantly increased, resulting in a reduced pelvic incidence–lumbar lordosis mismatch.Conclusion: PVP provides meaningful clinical improvement in thoracolumbar OVCFs and offers early vertebral height restoration; however, this radiologic benefit is not sustained over time. While limited improvement in lumbar lordosis was observed, PVP does not substantially correct global sagittal alignment. These findings suggest that PVP should be considered primarily a pain-relieving and stabilizing procedure rather than a deformity-correcting intervention.