Consult and kyphoplasty delay impacts on geriatric vertebral compression fracture outcomes

Objective To determine the association between the delay in a neurosurgical consultation and subsequent kyphoplasty following the radiological diagnosis of a vertebral compression fracture (VCF), and surgical outcomes. Methods A retrospective cohort study was conducted on elderly patients (60 years or older) who underwent kyphoplasty at Hamilton Health Sciences (HHS) between 2012 and 2022, with a prior admission under Internal Medicine or non-spine-surgical specialties at HHS within two years prior to surgery. The primary outcomes were the progression of vertebral height loss and focal kyphotic deformity at diagnosis, prior to kyphoplasty, and post-kyphoplasty. Results The study included 108 patients (53.7 % female, 46.3 % male, mean age 70.5 years), with 119 surgeries. Thoracic and lumbar spine VCFs were present in 60 (55.6 %) and 76 (70.4 %) patients, respectively. A significant increase in vertebral height loss was observed before kyphoplasty (8.45 %; 95 % CI 4.70 % – 12.21 %, p < 0.0001) and a robust augmentation of vertebral height was observed after kyphoplasty (−6.81 %; 95 % CI −12.07 % – −1.55 %, p = 0.0122). However, no significant correlations were found between delay times and changes in vertebral height or focal kyphotic deformity. Conclusion Delays in neurosurgical consultation and kyphoplasty do not significantly affect radiographic outcomes in elderly patients with VCF. Despite restoration of vertebral height loss, the timing of intervention post-diagnosis does not influence the radiographic outcomes studied. This finding emphasizes the need for timely patient care while suggesting that delayed treatment might not adversely affect certain key radiographic metrics in elderly VCF patients.