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Vertebral augmentation provides better survival in patients with vertebral compression fractures
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Researchers comparing various vertebral augmentation procedures for the treatment of vertebral compression fractures found the procedures were associated with greater patient survival than nonoperative treatment, according to research recently published in the Journal of Bone & Joint Surgery.
“Our results suggest that the beneficial impact of minimally invasive surgery for vertebral compression fractures reaches beyond the acute phase and improves post-discharge survival and morbidity,” Richard L. Skolasky Jr., ScD, associate professor at The Johns Hopkins Hospital’s Department of Orthopedic Surgery and Spine Outcomes Research Center, stated in a press release.
The researchers examined Kaplan-Meier and Cox regression analysis results from the 2006 Medicare Provider Analysis and Review File database for 68,752 patients who underwent nonoperative treatment, kyphoplasty or vertebroplasty. They found 3-year survival rates were 42.3% for nonoperative treatment, 49.7% for vertebroplasty and 59.9% for kyphoplasty, according to the abstract. Kyphoplasty patients had a 20% lower mortality risk, shorter length of stay and were less likely to develop pneumonia and decubitus ulcers during their hospital stay and at 6-months postoperatively than patients who underwent vertebroplasty.
Skolasky and colleagues said although patients in the kyphoplasty group had higher patient survival than vertebral augmentation, the treatment is expensive and carries a greater risk of subsequent vertebral fracture, according to the abstract. They noted selection bias could be present in the study and recommended a prospective study directly comparing vertebral compression fracture treatments.
“Despite these limitations, our study did capture a large percentage of the elderly population that was acutely hospitalized for treatment and also assessed long-term complications and survival,” Skolasky said.
Reference:
Chen AT. J Bone Joint Surg Am. 2013;doi:10.2106/JBJS.K.01649.
Disclosure: The authors have no relevant financial disclosures.