Getting It Right First Time Programme, NHS England and NHS Improvement, Wellington House, London, UK.
Royal National Orthopaedic Hospital, Stanmore, London, UK.
Arch Osteoporos. 2022 Jul 29;17(1):104. doi: 10.1007/s11657-022-01151-4.
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.
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.
This was an observational analysis of administrative data. Data were extracted from the Hospital Episodes Statistics database for the period 1 April 2011 to 31 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.
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.
With regard to the outcomes studied, there is no evidence that VP is associated with poorer outcomes than BKP.
我们回顾了椎体成形术和球囊椎体后凸成形术治疗骨质疏松性脊柱骨折的手术治疗结果。我们对英格兰在 7 年内进行的 5792 例椎体成形术和 3136 例球囊椎体后凸成形术的研究发现，没有证据表明与球囊椎体后凸成形术相比，椎体成形术患者的研究结果更差。
调查在英国国民保健制度下接受手术治疗的骨质疏松性脊柱骨折患者使用椎体成形术（VP）和球囊椎体后凸成形术（BKP）技术的使用情况、安全性和功能结果。
这是一项对行政数据的观察性分析。从 2011 年 4 月 1 日至 2018 年 3 月 31 日，从医院住院统计数据库中提取所有 VP 和 BKP 手术的数据。排除年龄<19 岁、患有转移性癌和接受其他减压手术的患者。主要结果是 1 年内再次脊柱手术。次要结果为 30 天内急诊再入院、1 年内死亡、延长住院时间、30 天内术后疼痛和 30 天内术后出血或感染。采用多水平、多变量逻辑回归来调整协变量。
96 家医院信托机构为 5792 例 VP 和 3136 例 BKP 患者提供了数据。在研究期间进行了超过 20 例手术的 63 家信托机构中，BKP 手术的比例从 0 到 100%不等。VP 患者和 BKP 患者之间或进行≥70%和≤30%BKP 手术的信托机构之间，在任何结果方面均无差异。
就研究的结果而言，没有证据表明 VP 比 BKP 更差。
