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Cement Augmentation of Vertebral Compression Fractures May Be Safely Considered in the Very Elderly

Neurospine 2021년 18권 1호 p.226 ~ 233
Galivanche Anoop R., Toombs Courtney, Adrados Murillo, David Wyatt B., Malpani Rohil, Saifi Comron, Whang Peter G., Grauer Jonathan N., Varthi Arya G.,
소속 상세정보
 ( Galivanche Anoop R. ) - Yale School of Medicine Department of Orthopaedics and Rehabilitation
 ( Toombs Courtney ) - Yale School of Medicine Department of Orthopaedics and Rehabilitation
 ( Adrados Murillo ) - Yale School of Medicine Department of Orthopaedics and Rehabilitation
 ( David Wyatt B. ) - Yale School of Medicine Department of Orthopaedics and Rehabilitation
 ( Malpani Rohil ) - Yale School of Medicine Department of Orthopaedics and Rehabilitation
 ( Saifi Comron ) - University of Pennsylvania Department of Orthopaedic Surgery
 ( Whang Peter G. ) - Yale School of Medicine Department of Orthopaedics and Rehabilitation
 ( Grauer Jonathan N. ) - Yale School of Medicine Department of Orthopaedics and Rehabilitation
 ( Varthi Arya G. ) - Yale School of Medicine Department of Orthopaedics and Rehabilitation

Abstract


Objective: The objective of the current study was to perform a retrospective review of a national database to assess the safety of cement augmentation for vertebral compression fractures in geriatric populations in varying age categories.

Methods: The 2005?2016 National Surgical Quality Improvement Program databases were queried to identify patients undergoing kyphoplasty or vertebroplasty in the following age categories: 60?69, 70?79, 80?89, and 90+ years old. Demographic variables, comorbidity status, procedure type, provider specialty, inpatient/outpatient status, number of procedure levels, and periprocedure complications were compared between age categories using chi-square analysis. Multivariate logistic regressions controlling for patient and procedural variables were then performed to assess the relative periprocedure risks of adverse outcomes of patients in the different age categories relative to those who were 60?69 years old.

Results: For the 60?69, 70?79, 80?89, and 90+ years old cohorts, 486, 822, 937, and 215 patients were identified, respectively. After controlling for patient and procedural variables, 30-day any adverse events, serious adverse events, reoperation, readmission, and mortality were not different for the respective age categories. Cases in the 80- to 89-year-old cohort were at increased risk of minor adverse events compared to cases in the 60- to 69-year-old cohort.

Conclusion: As the population ages, cement augmentation is being considered as a treatment for vertebral compression fractures in increasingly older patients. These results suggest that even the very elderly may be appropriately considered for these procedures (level of evidence: 3).

키워드

Vertebroplasty; Kyphoplasty; Elderly; Nonagenarian; Geriatrics

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