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Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the effects of percutaneous kyphoplasty (PKP) with or without posterior pedicle screw fixation (PPSF) on spinal sagittal balance in elderly patients with severe osteoporotic vertebral compression fracture (sOVCF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January 2016 to December 2018, 102 elderly patients with single-level thoracolumbar sOVCF were enrolled. Among them, 78 cases underwent PKP (Group A), and 24 cases underwent PPSF+KP (Group B). Clinical evaluation included perioperative parameters, Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back pain; Radiographic evaluation included anterior vertebral height (AVH) and rate (AVHr), local kyphotic angle (LKA), and spino-pelvic sagittal balance parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Perioperative parameters including operation time, blood loss, fluoroscopic time and hospital stay in Group A were less than those in Group B (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). Compared with the pre-operative results, the ODI and VAS scores of both groups decreased significantly in the three follow-ups after surgery (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). The post-operative ODI and VAS scores of Group A were significantly better than those of Group B, but the results were opposite at the final follow-up (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). Compared with the pre-operative values, except that there was no significant difference in pelvic incidence (PI) (<jats:italic>p<\/jats:italic> &amp;gt; 0.05), other radiographic parameters of both groups were improved significantly in the three follow-ups after surgery (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). The AVH, AVHr, LKA and lumbar lordosis (LL) in Group B were better than those in Group A in the three follow-ups after surgery (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). At the final follow-up, the sacral slope (SS) and pelvic tilt (PT) differed significantly between the two groups (<jats:italic>p<\/jats:italic> &amp;lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both PPSF+KP and PKP can achieve favorable clinical outcomes and maintain the spinal sagittal balance. Compared with PPSF+KP, PKP showed more significant advantages in the early post-operative period. However, in the long-term follow-up, PPSF+KP showed better clinical outcomes and may be better than PKP in maintaining spinal sagittal balance.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.800664","type":"journal-article","created":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T04:50:55Z","timestamp":1645159855000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of Percutaneous Kyphoplasty With or Without Posterior Pedicle Screw Fixation on Spinal Sagittal Balance in Elderly Patients With Severe Osteoporotic Vertebral Compression Fracture: A Retrospective 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