Percutaneous vertebral augmentation for acute traumatic vertebral Fractures: A TQIP database study

Abstract

Patients with vertebral fractures may be treated with percutaneous vertebroplasty (VP) and kyphoplasty (KP) for pain relief. Few studies examine the use of VP and KP in the setting of an acute trauma. In this study, we describe the current use of VP/KP in patients with acute traumatic vertebral fractures. All patients in the ACS Trauma Quality Improvement Program (TQIP) 2016 National Trauma Databank with severe spine injury (spine AIS ≥ 3) met inclusion criteria, including patients who underwent PVA. Logistic regression was used to assess patient and hospital factors associated with PVA; odds ratios and 95 % confidence intervals are reported. 20,769 patients met inclusion criteria and 406 patients received PVA. Patients aged 50 or older were up to 6.73 (2.45 – 27.88) times more likely to receive PVA compared to younger age groups and women compared to men (1.55 [1.23–1.95]). Hospitals with a Level II trauma center and with 401–600 beds were more likely to perform PVA (2.07 [1.51–2.83]) and (1.82 [1.04–3.34]) respectively. African American patients (0.41 [0.19–0.77]), isolated trauma (0.64 [0.42–0.96]), neurosurgeon group size > 6 (0.47 [0.30–0.74]), orthopedic group size > 10, and hospitals in the Northeastern and Western regions of the U.S. (0.33 [0.21–0.51] and 0.46 [0.32–0.64]) were less likely to be associated with PVA. Vertebroplasty and kyphoplasty use for acute traumatic vertebral fractures significantly varied across major trauma centers in the United States by multiple patient, hospital, and surgeon demographics. Regional and institutional practice patterns play an important role in the use of these procedures.