Risk and benefit evaluation of balloon dilation combined with prying reduction and bone grafting for thoracolumbar fractures based on multi-criteria decision

WEI Ran; HE Yin-chuan; YAO Xue-ying; CAO Peng; LIU Ming-hao; XU Jun-ling

doi:10.3969/j.issn.2095-252X.2025.03.004

Abstract：Objective To explore the clinical value of balloon dilation(BD)combined with prying reduction and bone grafting in preventing delayed kyphosis after osteoporotic thoracolumbar fracture(OTF)surgery.Methods Denis A type thoracolumbar compression fractures(TLCF)patients(72 cases)admitted to our hospital from January 2020 to July 2022 were selected as the research subjects.Random number table method was used and all patients were divided into observation group(BD combined with prying reduction and bone grafting surgery)and control group[short-segment pedicle screw fixation(SPSF)],with 36 cases in each group.X-ray was used to observe the relative vertebral height and Cobb's angle of patients before and after surgery,and clinical data such as Oswestry dysfunction index(ODI),visual analogue(VAS)score,barthel index(BI),and Frankel grading of neurological function(B-E)were compared between the two groups of patients.Multi-criteria decision analysis(MCDA)model was established for the treatment of OTF with BD combined with prying reduction and bone grafting.Results There were significant differences in surgical time,intraoperative blood loss,clinical efficacy,and incidence of adverse reactions between the two groups of patients(P<0.05).After surgical treatment,there were significant differences between the two groups of patients in terms of anterior vertebral height(AVH),midline vertebral height,posterior vertebral height,Cobb's angle,ODI,BI index,VAS score,and Frankel grading of neurological function(P<0.05).The observation group had more benefits and lower risks,with 100%superiority over the control group.The stability of the MCDA model was good.Conclusions Compared with SPSF surgery,the benefits of BD combined with prying reduction and bone grafting are more than the risks for treating OTF,making it an ideal method.Meanwhile,it can reconstruct and maintain the height of the injured vertebra and spinal stability,further effectively reduce the incidence of kyphosis.