Symptom Duration and Age as Predictors of Early Pain Reduction After Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures: A Retrospective Cohort Study in Indonesia

Abstract

Background: Osteoporotic vertebral compression fractures (OVCFs) cause disabling pain and kyphosis. Balloon kyphoplasty (BKP) provides rapid stabilization, but predictors of early pain relief remain debated in Southeast Asian populations.

Objective: To identify clinical and radiological predictors of early pain reduction after BKP for OVCFs in an Indonesian tertiary referral cohort.

Methods: This retrospective cohort study analyzed 30 consecutive patients with OVCFs (age ≥ 50 years; bone mineral density T-score ≤ −2.5) treated with BKP at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia (January 2024–December 2025). Numerical Pain Rating Scale (NPRS) scores were recorded preoperatively and at discharge (24–48 hours). Seven candidate predictors (age, sex, T-score, kyphotic angle, symptom duration, treated levels, preoperative NPRS) were assessed with bivariate correlation and stepwise multivariable linear regression (screening p < 0.25).

Results: Mean age was 67.2 ± 7.39 years (range 54–82); 24 patients (80.0%) were women. NPRS decreased from 7.43 ± 0.77 to 2.80 ± 0.81 (mean reduction 4.63 ± 1.16 points; 62.3%; p < 0.001). Six variables were significant in bivariate analysis. Duration of complaints (β = −1.881; 95% CI −2.452 to −1.310; p < 0.001) and age (β = −0.428; 95% CI −0.831 to −0.025; p = 0.039) remained independent predictors (R² = 0.723; adjusted R² = 0.702; F = 35.579; p < 0.001). Asymptomatic cement leakage occurred in two patients (6.7%), without severe complications.

Conclusion: BKP was followed by substantial early pain reduction with few complications. Shorter symptom duration and younger age were independently associated with greater early relief, suggesting that earlier treatment may improve outcomes.