Conclusion
The percutaneous balloon kyphoplasty with PMMA is recommended for the relief of pain among extremely senile patients with complicated comorbid diseases. The results presented here show that, after adjustment for gender, fracture level and age, kyphoplasty was superior to other surgical techniques in restoring the kyphotic deformity of collapsed vertebral bodies in VCF patients. The use of short-segment fixation with I-VEP to preserve AH below and KA above the fractured vertebra kept the adjacent segments intact, which may offer an alternative treatment for patients with VCF. This approach offers a comparable level of pain relief, maintains the integrity of adjacent structures, and reduces the likelihood of a domino effect up to one year postoperatively. However, the immediate and early pain relief achieved with kyphoplasty may be more meaningful than the long-term prevention of a domino effect in extremely senile patients with comorbidities. Further research about the biomechanical stability of the spine in this context and more long-term clinical data will be needed to definitively evaluate the role of the two techniques in the treatment of patients with osteoporotic vertebral compression fracture.