Bracing versus balloon kyphoplasty for acute osteoporotic vertebral fractures with poor prognostic radiological factors: a propensity score-matched comparison
Authors' conclusion
In acute OVFs with poor prognostic radiological factors, early BKP did not provide superior 12-week pain relief compared with bracing after adjustment for baseline confounders. However, BKP was more effective in limiting early vertebral body collapse.
Study context
- Population
- Patients aged ≥65 years with acute osteoporotic vertebral fractures with fluid or diffuse low-intensity signal on T2-weighted magnetic resonance imaging (MRI) and back pain visual analog scale (VAS) ≥4/1042 matched pairs analysed
- Participants
- 82 vs 62
- Exposure
- Early balloon kyphoplasty vs bracing
- Balloon kyphoplasty (BKP)n = 82
- Bracen = 62reference
- Outcome
- Back pain VAS
- Follow-up
- 12 weeks
Methodological detailsprospective cohort vs historical controls, propensity-score matched (1:1 on age, sex, fracture location), prospective BKP cohort, historical brace-treated controls from a prior randomised trial
- Prospective cohort vs historical controls
- Propensity-score matched (1:1 on age, sex, fracture location)
- Prospective BKP cohort
- Historical brace-treated controls from a prior randomised trial
Main finding
As reported in the abstract
BKP
23.5
± 20.7
Brace
27.2
± 21.0
P = 0.45
Observational data: associations, not effects.
Secondary outcomes
Anterior vertebral body compression percentage (AVBCP), after propensity score matching · 12 weeks · AVBCP significantly higher with BKP · propensity score matched
P < 0.0001
AVBCP, crude analysis · 12 weeks · crude analysis
P < 0.0001
| Outcome | BKP | Brace | P value |
|---|---|---|---|
| Back pain VAS, crude analysis · 12 weeksCrude analysis | 21.8 ± 19.5 | 30.2 ± 23.3 | P = 0.047 |
Back pain VAS change from baseline to 12 weeks, within group
- BKP: from 73.6 ± 27.3 to 21.8 ± 19.5
- P < 0.0001
- Brace: from 74.9 ± 23.9 to 30.2 ± 23.3
- P < 0.0001
Original publication
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