A Comparison of Treatments for Osteoporotic Vertebral Compression Fractures
Conservative Treatment vs. Kyphoplasty
A recent study led by researchers in South Korea explored the clinical outcomes of patients with osteoporotic vertebral compression fractures (OVCFs) who underwent different treatments for the condition.
The study, “Comparative analysis of clinical outcomes in patients with osteoporotic vertebral compression fractures (OVCFs): conservative treatment versus balloon kyphoplasty,” compared patients’ outcomes following 3 weeks of conservative treatment only, and a combination of conservative treatment and balloon kyphoplasty. The study was published online ahead of print in September 2012 in The Spine Journal.
The researchers examined data from case reports on 259 patients. All of the patients in the study had 1 or 2 acute painful OVCFs (the fractures were confirmed using an MRI). The patients first received conservative treatment for 3 weeks. Following this period, 91 of the patients who still suffered from back pain or disability were treated with kyphoplasty.
Patients’ pain was measured using the visual analog scale (VAS) and the Oswestry Disability Index (ODI). The VAS scores were assessed at 1 week, and also at 1, 3, 6, and 12 months.
The results showed that conservative treatment was successful in approximately 65% of the patients. Some of the factors that lowered a patient’s risk of being successfully treated with 3 weeks of conservative treatment were: being older (> 78.5 years old); being overweight (BMI > 25.5); and having severe osteoporosis (t-score < -2.95).
Additionally, during the first month of pain assessment, better clinical results were seen in the patients who had the kyphoplasty. However, no significant differences were seen between the treatment groups at the 3, 6, or 12 month marks.
The researchers argue that their study demonstrates that both OVCF treatments resulted in successful clinical results at the end of 1 year. They state that patients should not automatically be prescribed kyphoplasty, particularly if they may be successfully healed with conservative treatment only.