Analysis of Fractures and Mortality Following Balloon Kyphoplasty and Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Retrospective Clinical Study

Background: Osteoporotic vertebral compression fractures (OVCFs) are a major cause of morbidity in the elderly and are associated with increased mortality. Balloon kyphoplasty is a minimally invasive procedure that provides rapid pain relief and early mobilization. However, the relative contributions of fracture- and patient-related factors to long-term survival remain unclear.Methods: This retrospective study included 182 patients who underwent balloon kyphoplasty for OVCFs. Demographic characteristics, vertebral fracture level, additional osteoporotic fractures, and survival data were obtained from medical records. Vertebral fractures were categorized as thoracolumbar (T8–L2) or lumbar (L3–L5). Overall survival was defined as the interval between surgery and death or last follow-up. Univariable Cox regression identified factors associated with mortality, with hazard ratios (HRs) and 95% confidence intervals (CIs) reported.Results: During follow-up, 33 patients (18.1%) died. Mean overall survival was 76.84 ± 2.95 months (95% CI: 71.06–82.63). Age was the only variable significantly associated with mortality (HR: 1.055, 95% CI: 1.016–1.094; p = 0.005). Vertebral fracture level, additional osteoporotic fractures, diabetes mellitus, pulmonary disease, cardiovascular disease, malignancy, neurological disease, and ASA classification were not significantly associated with mortality (all p > 0.05).Conclusion: Survival after balloon kyphoplasty was more strongly associated with patient-related factors than fracture characteristics. Age was the only factor significantly associated with mortality, whereas vertebral fracture level and additional osteoporotic fractures were not associated with survival. These findings emphasize considering patient condition and frailty rather than radiological findings alone when evaluating prognosis.