BEYOND PAIN RELIEF: COMPARATIVE EFFECTIVENESS OF VERTEBROPLASTY, KYPHOPLASTY, AND CONSERVATIVE TREATMENT IN 428 GERIATRIC OSTEOPOROTIC VERTEBRAL FRACTURES

Abstract

Introduction: Osteoporotic vertebral compression fractures represent an important source of pain, functional limitation, and deterioration in quality of life among elderly individuals. However, the most appropriate treatment approach is still debated, especially when comparing the effectiveness of vertebral augmentation procedures with conservative management methods. Materials and Method: A cohort of 428 individuals aged 65 years and older with radiologically confirmed osteoporotic vertebral compression fractures and at least 12 months of follow-up were retrospectively analyzed in this study. Participants were allocated into three treatment groups consisting of vertebroplasty (n=123), kyphoplasty (n=111), and conservative management (n=194). Clinical efficacy was determined using the Visual Analog Scale and Oswestry Disability Index, whereas radiological evaluation focused on restoration of vertebral body height and correction of kyphotic deformity. Additionally, multivariate logistic regression analysis was performed to determine the independent factors associated with unfavorable clinical outcomes. Results: All groups demonstrated significant clinical improvement; however, the vertebral augmentation groups showed significantly greater and earlier reductions in clinical scores compared to the conservative treatment group (p < 0.001). Kyphoplasty achieved superior restoration of vertebral body height and improvement in kyphotic deformity (p < 0.001), with lower cement leakage rates (p = 0.02). Conservative treatment, multi-level fractures, and age > 80 years were independent predictors of poor outcomes. Conclusion: Vertebral augmentation provides faster and more effective clinical improvement than conservative management in geriatric osteoporotic vertebral compression fractures patients. While clinical outcomes are comparable, kyphoplasty offers superior radiological correction with a lower complication profile, supporting its role in selected patients. Keywords: Osteoporotic Fractures; Vertebroplasty; Kyphoplasty; Spinal Fractures.