Can Percutaneous Kyphoplasty Be a New Solution for Vertebral Fractures in Patients With Diffuse Idiopathic Skeletal Hyperostosis? Retrospective Study.

Background: Diffuse idiopathic skeletal hyperostosis (DISH) is a metabolic disease that is prevalent in elderly patients and is characterized by spinal ankylosis. Traditional surgical treatment requires open long-segment internal fixation. Percutaneous kyphoplasty (PKP), as a minimally invasive spinal surgery technology, can accurately relieve pain and improve quality of life. The objective of this study was to evaluate the efficacy and reliability of PKP in treating vertebral fractures with DISH.

Methods: We retrospectively investigated 209 patients with thoracic or lumbar fractures receiving PKP between January 2019 and December 2020. The patients were divided into 2 groups according to the diagnostic criteria. The anterior and posterior vertebral height restoration ratio and the local kyphotic angle (LKA) were used to evaluate the radiographic results. The visual analog scale score and the Oswestry Disability Index questionnaire were used for the assessment of the clinical function.

Results: The average age of the DISH group was significantly older than that of the non-DISH group ( < 0.05). The perioperative prognostic nutritional index measured in the DISH group was significantly worse than that in the non-DISH group ( < 0.05). PKP in DISH patients achieved a significant restoration in the anterior and posterior vertebral height restoration ratio between pre- and postoperative measurements ( < 0.05). The postoperative LKA was significantly corrected at 1 day, 1 month, and the last follow-up ( < 0.05). Significant reductions in visual analog scale and Oswestry Disability Index scores were obtained during follow-up ( < 0.05).

Conclusion: For vertebral fractures in elderly DISH patients, PKP may be effective and feasible, which restores the vertebral height, corrects the LKA, and achieves pain relief and satisfactory functional improvement.