Impact of surgical case order on percutaneous kyphoplasty for painful osteoporotic vertebral compression fracture: a retrospective study of 1214 cases

Abstract

Abstract Introduction Although percutaneous kyphoplasty (PKP) has been proven to be an effective approach for painful osteoporotic vertebral compression fracture (OVCF), controversy still exists regarding the effect of surgical case order on perioperative complications and clinical outcomes of PKP in the process of OVCF treatment. Methods A total of 1214 patients (1487 vertebral bodies) who were diagnosed with OVCFs and treated with PKP at our institution from January 2014 to December 2019 were retrospectively reviewed. All the enrolled patients were divided into four groups according to surgical case order. Demographic data and perioperative details were collected and analyzed. Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI) scores were recorded for the measurement of pain management. The anterior vertebral height restoration rate (AVHRR) and kyphotic Cobb angle correction rate (CR) were calculated to assess kyphosis correction. Binary logistic regression was used to elucidate the effect of surgical case order on bone cement leakage. Results The average age of the patients in the first case was significantly higher than that of the patients in the other three groups (P < 0.05). A significantly longer operative time of the first case was revealed compared to the others (P < 0.05). No difference in pain management and kyphosis correction was demonstrated among the four groups (P > 0.05). The incidence of cement leakage was found unchanged (P= 0.741). Surgical case order was proven not to be an independent risk factor for bone cement leakage (P = 0.675). Conclusion Surgical case order has no significant influence on perioperative complications and clinical or radiological outcomes of PKP.