A study of 69,000 Medicare patient records, published in of The Journal of Bone & Joint Surgery, shows that patients who undergo vertebral augmentation procedures have increased survival compared with those undergo conservative therapy. Additionally, kyphoplasty is associated with greater survival than vertebroplasty.
Richard L Skolasky, associate professor at The Johns Hopkins Hospital’s Department of Orthopaedic Surgery and Spine Outcomes Research Center (USA), and others conducted a post-hoc analysis and comparison of information on some 69,000 patients sorted into three categories of fracture care: non-operative, vertebroplasty and kyphoplasty. The team examined differences in survival at six months, one year, two years and three years along with complications, length of hospital stay, charges assessed by the discharging hospital and/or the healthcare provider delivering services, 30-day readmission rates and repeat procedures.
They found that found that vertebral augmentation procedures not only appear to be associated with greater patient survival than non-operative management, but also that kyphoplasty tends to have a more striking association with survival than vertebroplasty. The results showed that the overall survival rate for the entire study population was 77.8% at one year and 49.6% at three years. The kyphoplasty group had the highest survival rates at one and three years, at 85.2% and 59.9%, respectively. When examined by age, individuals in the kyphoplasty group consistently had higher survival rates. The study also discovered that patients treated non-operatively on average were hospitalised approximately eight days longer. Skolasky says: “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.”
The total charges for kyphoplasty and vertebroplasty were US$12,032 and US$7,805 more than those treated non-operatively. However, although the augmentation procedures were initially more expensive than conservative medical management of the fractures, Skolasky and others report the former were associated with lower in-hospital mortality and increased survival compared with non-operative management.