predictors of kyphosis progression after the conservative treatment of osteoporotic vertebral compression fracture

Background: in the patients with osteoporotic vertebral compression fracture (ovcf) treated conservatively, significant progression of the local kyphosis due to an impaired healing leads to reduction in the quality of life. thus, it is of critical value to identify the predictors of this major complication. objectives: the current prospective cohort study aimed at evaluating the predictors of progression in the local kyphosis in a series of patients with acute ovcf undergoing conservative treatment. methods: eligible patients with ovcf were identified and local kyphosis progression was evaluated after four months of conservativetreatment. demographic characteristics such as gender, age, and body mass index (bmi), as well as radiographic characteristics such as the location of fracture, bone mineral density (bmd), andserum 25 (oh) vitamin d level were compared between the patients with local kyphosis angle (lka) progressed≥ 30° (group a) and the patients with lka remained < 30° (group b). results: from a total of 60 patients with ovcf, lka progressed ≥ 30° in 19 patients (31.7%). the mean change of lka was 16.2°±7.2° in group a and 1.92° ± 2.7° in group b (p < 0.001). higher age, lower bmi, and lower spinal bmd were significantly associated with lka progression ≥ 30° (p = 0.013, p < 0.001, and p = 0.037, respectively). the involvement of thoracolumbar junction (t11-l1) was more frequent in group a (p = 0.049). anterior cortical wall fracture was more frequent in group a as well (p = 0.007). after adjustment of confounding factors, the association of lka progression with the age, bmi, and the level of fractured vertebra still remained significant. conclusions: significant progression of lka following conservative treatment of ovcf is correlated with the level of fractured vertebra, bmi, and age of the patients.these factors could be used to select patients most benefit from conservative treatment.