Prognostic Factors for Pain Reduction After Balloon Kyphoplasty in Osteoporotic Vertebral Compression Fractures: A Case Series

Rachmad Susilo (Department of Orthopedics Surgery and Traumatology, Universitas Sriwijaya, Palembang, Indonesia)
Rendra Leonas (Department of Orthopedics Surgery and Traumatology, Universitas Sriwijaya, Palembang, Indonesia)
Debby Handayati Harahap (Medical Study Program, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia)

Sriwijaya Journal of Surgery
Vol. 9 No. 1 (2026): Sriwijaya Journal of Surgery

Introduction: Osteoporotic vertebral compression fractures (OVCFs) are a leading cause of morbidity and disability worldwide. While balloon kyphoplasty provides significant pain relief, prognostic factors for optimal pain reduction outcomes remain debated, particularly in Southeast Asian populations with distinct epidemiological characteristics. Methods: A retrospective case series analysis of 30 patients with OVCFs who underwent balloon kyphoplasty at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, between January 2024 and December 2025. Pain was assessed using the Numerical Pain Rating Scale (NPRS) before surgery and at discharge. Seven potential prognostic variables were examined: age, gender, bone mineral density (BMD), kyphotic angle, duration of complaints, number of vertebral levels treated, and preoperative pain severity. Bivariate analysis using Pearson and Spearman correlation coefficients was performed, followed by multivariate linear regression analysis with entry criteria of p < 0.25. Results: Mean age was 67.2 ± 7.39 years (range 54-82 years), with 80% female patients (n = 24). Pain scores decreased significantly from a preoperative mean of 7.43 ± 0.77 to a postoperative mean of 2.8 ± 0.81 (p < 0.001), representing a 62.3% reduction. Bivariate analysis revealed significant associations for six variables. Multivariate regression analysis identified two independent prognostic factors: duration of complaints (β = -1.881, p < 0.001) and age (β = -0.428, p = 0.039), with an adjusted R² of 0.702. Patients with shorter symptom duration and younger age experienced greater pain reduction. Asymptomatic cement leakage occurred in two patients (6.7%), with no serious complications observed. Conclusion: Balloon kyphoplasty effectively reduces pain in osteoporotic vertebral compression fractures. Duration of complaints and patient age are independent prognostic factors for pain reduction outcomes. These findings may guide patient selection and expectation management in clinical practice.