A new study published in Spine examines the outcomes for vertebral compression fracture treatment in the Medicare population.
The researchers examined more than 1 million patients, including 141,343 patients who underwent balloon kyphoplasty and 75,364 patients who underwent vertebroplasty for vertebral compression fractures. The researchers examined data from the US Medicare data set from 2005 to 2009.
There were also patients who underwent conservative nonoperative treatment. The researchers found:
1. Patients in the nonoperative cohort had a 55 percent higher adjusted risk of mortality than the kyphoplasty group and 25 percent higher adjusted risk of mortality than the vertebroplasty group.
2. The kyphoplasty group had 19 percent lower adjusted risk of mortality than the vertebroplasty group.
3. There were similar mortality findings for pneumonia diagnoses within 90 days before surgery, even after propensity matching. This was also true for the osteoporotic VCF patient subgroups including those who survived at least one year as well as those without a cancer diagnosis.
4. The nonoperative cohort had significantly higher adjusted risks of pneumonia, myocardial infarction/cardiac complications, DVT and urinary tract infection than the kyphoplasty cohort with propensity matching.
5. The nonoperative cohort had lower adjusted risks of subsequent augmentation/fusion, subsequent augmentation and pulmonary/respiratory complications.
6. The kyphoplasty group had significantly lower morbidity than the vertebroplasty cohort, except for deep venous thrombosis, infection and myocardial infarction/cardiac complications which were similar in both groups.