Minimally Invasive Treatment Using Biportal Endoscopic Decompression with Vertebroplasty for Osteoporotic Vertebral Compression Fractures in Older Adult Patients.

Backgroud: Osteoporotic vertebral compression fractures (OVCFs) with neurological symptoms often require extensive fusion surgery, which carries significant risks for older adults. This study evaluated the clinical outcomes of biportal endoscopic lumbar decompression (BELD) combined with percutaneous vertebroplasty (PVP) as a minimally invasive alternative. Methods: We retrospectively analyzed 21 older adults (mean age, 80.24 years) who underwent BELD with PVP for OVCFs between July 2017 and June 2022. Indications included neurological deficits or severe, intractable pain refractory to conservative treatment. Clinical outcomes were assessed using the visual analog scale (VAS), Oswestry Disability Index (ODI), European Quality of Life-5 Dimensions (EQ-5D), and modified MacNab criteria. Radiographic parameters included vertebral compression rate and wedge angle. Results: The mean operation time was 86.81 minutes, with an average blood loss of 136.19 mL. According to modified MacNab criteria, 76.2% of patients achieved excellent or good outcomes. Clinical parameters, including VAS, ODI, and EQ-5D, showed significant improvement over 24 months ( Conclusions: BELD combined with PVP is a safe and effective, minimally invasive option for older adults with OVCFs and neurological symptoms. This technique provides adequate neural decompression and vertebral stabilization while minimizing the risks associated with extensive fusion surgery in this vulnerable population.