Does Clinical Improvement Translate to Satisfaction? Decisional Regret One Year After Balloon Kyphoplasty for Osteoporotic Vertebral Fractures in 187 Patients

Purpose : This study evaluates decisional regret one year after balloon kyphoplasty for osteoporotic vertebral compression fractures and its association with clinical outcomes. Methods : In this single-center retrospective study, 187 patients (mean age 77.60 ± 11.56 years, 58.8% female) who underwent balloon kyphoplasty between January 2022 and December 2022 were assessed. Outcomes included Oswestry Disability Index (ODI), Visual Analog Scale (VAS), kyphotic angle, and Decision Regret Scale (DRS) scores at one-year follow-up. Statistical analyses included paired t-tests, Pearson correlations, and chi-square tests. Results : Most patients (79.1%) reported no/mild regret (DRS 0–25), 20.9% had moderate regret (DRS 26–65), and none had high regret. Significant improvements were observed in ODI (40.14 ± 12.19 points), VAS (4.26 ± 2.23 points), and kyphotic angle (12.98 ± 3.98°; all p < .001). Clinical improvements showed no correlation with DRS scores (p > .05). Cement leakage occurred in 3.7% of cases without clinical symptoms. Conclusion : Balloon kyphoplasty is associated with low decisional regret, supporting its role as a well-accepted treatment. Comprehensive preoperative counseling is essential to optimize patient satisfaction.