Genant grade-based stratification in percutaneous curved kyphoplasty: Superior early analgesic efficacy and cement distribution characteristics in moderate to severe osteoporotic vertebral compression fractures.

Osteoporotic vertebral compression fractures (OVCFs) have a high incidence and seriously affect the physical and mental health of the elderly. Percutaneous curved kyphoplasty (PCKP) has been proved to be one of the safe and effective treatment methods, but its efficacy in OVCFs with different compression degrees needs to be further clarified, Especially in the treatment of moderate and severe OVCFs. To evaluate the differential early outcomes and cement characteristics of Percutaneous Curved Kyphoplasty (PCKP) in treating osteoporotic vertebral compression fractures (OVCF) stratified by Genant severity grades. In this retrospective study, 114 patients with single-level OVCF treated with PCKP were categorized into mild (Genant grade 0-1, n = 30), moderate (grade 2, n = 48), and severe (grade 3, n = 36) compression groups. Primary outcomes included Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) assessed preoperatively and at 2 days, 3 months, and 12 months postoperatively. Secondary outcomes encompassed cement dosage, distribution quality, leakage, and refracture rates. All groups demonstrated significant improvement in VAS and ODI postoperatively (P < 0.05). At 2 days, the moderate and severe groups exhibited superior pain relief compared to the mild group (P < 0.05), though this difference equilibrated at 3 and 12 months. Cement dosage inversely correlated with compression severity (mild: 4.63 ± 0.90 ml, moderate: 4.09 ± 0.63 ml, severe: 3.21 ± 0.49 ml; P < 0.05), while the cement leakage rate exhibited a positive correlation (mild: 13.33%, moderate: 16.67%, severe: 22.22%; P > 0.05). No significant intergroup differences were observed in excellent cement distribution (P = 0.92) or refracture rates (P = 0.90). PCKP provides significant and rapid early pain relief, particularly in moderate to severe OVCFs. While the technique achieves excellent cement distribution across all severity levels, the risk of cement leakage escalates with increasing vertebral compression, necessitating meticulous surgical technique.