An observational study of vertebroplasty and kyphoplasty for osteoporotic spinal fractures: utilisation and outcomes in England using an administrative dataset,Archives of Osteoporosis

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An observational study of vertebroplasty and kyphoplasty for osteoporotic spinal fractures: utilisation and outcomes in England using an administrative dataset
Archives of Osteoporosis ( IF 3 ) Pub Date : 2022-07-29 , DOI: 10.1007/s11657-022-01151-4
William K Gray ₁ , Jamie Day ₁ , Tim W R Briggs _{1,

2} , Mike Hutton _{1,

3}

Affiliation

Summary

We reviewed outcomes for vertebroplasty and balloon kyphoplasty for the surgical treatment of osteoporotic spinal fracture. Our study of 5792 vertebroplasty and 3136 balloon kyphoplasty procedures conducted in England over a 7-year period found no evidence that the patient outcomes studied were poorer for vertebroplasty than for balloon kyphoplasty.

Purpose

To investigate use, safety and functional outcomes of vertebroplasty (VP) and balloon kyphoplasty (BKP) techniques for osteoporotic spinal fracture for patients operated on within the National Health Service in England.

Methods

This was an observational analysis of administrative data. Data were extracted from the Hospital Episodes Statistics database for the period 1^st April 2011 to 31^st March 2018 for all VP and BKP procedures. Patients aged < 19 years, with metastatic carcinoma and undergoing other decompression procedures, were excluded. The primary outcome was repeat spinal surgery within 1 year. Secondary outcomes were 30-day emergency readmission, death within 1 year, extended hospital stay, post-procedural pain within 30 days and post-procedural haemorrhage or infection within 30 days. Multilevel, multivariable logistic regression was used to adjust for covariates.

Results

Data were available for 5792 VP and 3136 BKP patients operated on at 96 hospital trusts. In the 63 trusts that conducted more than 20 procedures during the study period, the proportion of procedures conducted as BKP varied from 0 to 100%. There was no difference in any of the outcomes between VP and BKP patients or between trusts performing ≥ 70% and ≤ 30% of procedures as BKP.

Conclusions

With regard to the outcomes studied, there is no evidence that VP is associated with poorer outcomes than BKP.

中文翻译：

一项针对骨质疏松性脊柱骨折的椎体成形术和后凸成形术的观察性研究：使用管理数据集在英格兰的应用和结果

概括

我们回顾了椎体成形术和球囊后凸成形术手术治疗骨质疏松性脊柱骨折的结果。我们对 7 年期间在英格兰进行的 5792 例椎体成形术和 3136 例球囊后凸成形术的研究没有发现证据表明椎体成形术的患者结果比球囊后凸成形术差。

目的

调查椎体成形术 (VP) 和球囊后凸成形术 (BKP) 技术在英格兰国家卫生服务体系内对骨质疏松性脊柱骨折患者进行手术的使用、安全性和功能结果。

方法

这是对行政数据的观察分析。^{从 2011 年 4 月 1日}至 2018 年 3 月 31^日期间的所有 VP 和 BKP 程序的医院事件统计数据库中提取数据。年龄 < 19 岁、患有转移癌并接受其他减压手术的患者被排除在外。主要结果是 1 年内重复脊柱手术。次要结果是 30 天紧急再入院、1 年内死亡、延长住院时间、30 天内出现术后疼痛以及 30 天内出现术后出血或感染。使用多级、多变量逻辑回归来调整协变量。

结果

可获得在 96 家医院进行手术的 5792 名 VP 和 3136 名 BKP 患者的数据。在研究期间进行了 20 多个程序的 63 家信托中，作为 BKP 进行的程序的比例从 0 到 100% 不等。VP 和 BKP 患者之间或执行 ≥ 70% 和 ≤ 30% 手术作为 BKP 的信托之间的任何结果都没有差异。