Introduction: All osteoporotic fractures are associated with difficulties in obtaining activities of daily living (ADL) and maintaining quality of life (QOL) before the injury. In recent years, surgical treatment has been used for pain relief, early release from bed and return to society, prevention of vertebral progression at the fracture site, and spinal alignment. The purpose of this study was to investigate the effect of early intervention of percutaneous balloon kyphoplasty (BKP) for osteoporotic vertebral fracture (OVF) on the quality of life in the elderly.
Materials: Patients were eligible for BKP for thoracolumbar OVF if any of the following conditions were met within 4 weeks of injury: 1) extensive intravertebral low intensity or localized high intensity change on T2-weighted images, 2) extensive intravertebral low intensity on T1-weighted images, 3) progressive intravertebral compression or kyphosis, or 4) ADL limitation on conservative therapy. The NPRS (Numeric Pain Rating Scale), time to postoperative discharge, and EQ-5D-5L (EuroQol 5 dimensions 5-level Japanese version) were compared between preoperative (including preinjury) and postoperative 1, 6, and 12 months (p<0.05).
Results: 88 patients (16/72 male/female, mean age 80.7 years) completed the follow-up. Their bone density T score was -2.18. The mean time to BKP intervention after injury was 15.4 days, and postoperative discharge was 16.1 days. Postoperative NPRS improved significantly (p<0.05). QOL at 1 month after surgery was similar to that before injury (p>0.05) and was maintained until 12 months (p>0.05). QOL of elderly patients over 80 years old was the same as before the injury from 1 month postoperatively (p>0.05) and was maintained thereafter. However, in 13 patients (13/88 14.8%) with postoperative secondary vertebral fractures, the EQ-5D-5L was significantly lower than before the injury.
Conclusions: The impact of early intervention of BKP surgery for OVF on the QOL of the elderly was investigated. The results showed that even elderly patients over 80 years old were able to return to society early and maintain the same quality of life as before the injury. However, postoperative secondary vertebral fractures affected the maintenance of QOL.