Osteoporotic vertebral compression fractures are a severe problem for the elderly, leading to poor quality of life (QoL) due to pain and deformity. Percutaneous kyphoplasty (PKP) offers satisfactory clinical efficacy and quickly ease thoracic/lumbar back pain. This study explained that anterior wall, posterior wall, and kyphotic angle of vertebral bodies of patients with or without intravertebral cleft were significantly improved immediately after surgery.

To assess percutaneous kyphoplasty (PKP) clinical efficacy on osteoporotic vertebral compression fractures (OVCFs) with or without intravertebral cleft (IVC).

A total of 309 OVCFs participants who operated with PKP between 2010 and 2016 were selected for the analysis. Based on the pre-operative magnetic resonance imaging, patients were categorised into two groups; intravertebral cleft (IVC) group and no intravertebral cleft (NIVC) group. Kyphotic angle (KA), anterior wall height (AWH), and posterior wall height (PWH) of the injured vertebral body were assessed pre-operatively, post-operatively, and at final follow-up.

Every patient completed a follow-up of 12~34 months. The rate of IVC was linked with lower bone mineral density (BMD) and older age. Both groups showed considerable improvement in kyphotic angle (KA), anterior wall height (AWH), and posterior wall height (PWH) of vertebral bodies following the operation. Also, the groups exhibited an almost similar improved Oswestry Disability Index (ODI) and visual analogue scale (VAS) scores. Both groups showed enhanced KA and reduced AWH at the final follow-up as compared to the quickly following the surgery. The kyphotic angle in the IVC group raised more considerably in one year following the surgery as compared to the NIVC group. The IVC group exhibited greater and consistent volume of injected bone cement. The incidence of bone cement leakage was also higher in the IVC group but with no statistic group difference.

According to the analysis findings, unilateral PKP was a safe and reliable therapy for OVCFs with IVC. Although, the IVC group exhibited a higher rate of bone cement leakage at the time of surgery and more critical KA rebound during the follow-up period. Consequently, to decrease the rate of bone cement leakage, it is essential to assess the pre-operative imaging and introduce the cement repetitiously and carefully. If cement leakages are detected, the injection should be terminated instantly. To stop KA rebound among individuals with OVCFs with IVC, there is a need of including longer rehabilitation interventions like displacing bending with squatting, wearing an appropriate brace, and performing an exercise to strengthen the low-back muscle. Extensive follow-up may be important for subjects with OVCFs with IVC.