Real-world rates and risk factors for subsequent treatment with vertebroplasty or balloon kyphoplasty after initial vertebral augmentation: a retrospective cohort study
Authors' conclusion
One in seven patients underwent subsequent treatment for vertebral fracture after initial vertebral augmentation. Baseline patient characteristics were associated with increased risk of subsequent fracture within 2 years, suggesting that a patient's natural history is strongly associated with risk of subsequent treatment rather than the initial surgical procedure itself.
Study context
- Population
- Adults who underwent balloon kyphoplasty (BKP)/vertebroplasty (VP) after a diagnosis of vertebral compression fracture in the preceding 12 months, 1 January 2008–30 June 2020, Optum Clinformatics Data Mart
- Participants
- 32,513 adults
- Exposure
- Subsequent treatment vs no subsequent treatment after initial BKP/VP
- Subsequent treatmentn = 5,035
- Outcome
- Incidence and predictors of additional VP or BKP after initial vertebral augmentation (proxy for subsequent symptomatic vertebral fracture)
- Follow-up
- Within 24 months
Methodological detailscommercial insurance claims data, survival analysis
- Commercial insurance claims data
- Survival analysis
Main finding
As reported in the abstract
Subsequent BKP/VP treatment · within 2 years
Adjusted hazard ratio (95% CI)
≥ 4 levels treated at initial BKP/VP
1.68(1.24–2.26)
Elixhauser Comorbidity Index ≥ 4
1.44(1.17–1.77)
Multiple myeloma
1.31(1.13–1.53)
Age < 70 yearsreduced hazard
0.81(0.74–0.89)
- Steroid use · estimate outside printed CI
- aHR 1.9 (95% CI 1.31–1.48)
- Underwent subsequent BKP/VP within 2 years
- 5035 (15.5%)
Observational data: associations, not effects.
Further findings
Single fracture level treated at subsequent BKP/VP
- Single fracture level treated
- 90%
Original publication
Real-world rates and risk factors for subsequent treatment with vertebroplasty or balloon kyphoplasty after initial vertebral augmentation: a retrospective cohort study. Osteoporos Int. Published 23 November 2024. doi:10.
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