{
  "abstract": "Background Pathologic vertebral compression fractures (pVCFs) are associated with significant pain and worsened quality of life. Spinal interventions such as kyphoplasty, vertebroplasty, and radiofrequency ablation can improve patient outcomes; however, there is a paucity of data on the optimal timing of these procedures. This study aims to evaluate the real-world effectiveness of inpatient spinal interventions versus conservative management (CM) for pVCF patients.Methods This is a retrospective cohort analysis of the Nationwide Readmissions Database from 2016 to 2022. Adult patients admitted non-electively for pathologic thoracolumbar wedge compression fractures were included. The primary outcome was hospital discharge to home. Outcomes for patients who underwent spinal intervention (kyphoplasty, vertebroplasty, and/or radiofrequency ablation) versus CM were compared using Poisson or logistic regression analyses.Results 2933 patients were included (median age 77 years, 54.1% female) of whom 921 (31.4%) underwent spinal intervention. Compared with CM, those who underwent intervention were significantly more likely to be discharged home (61.1% vs 52.5%; adjusted OR 1.50, 95% CI 1.11 to 2.03, P=0.009), had significantly longer lengths of hospital stay (median 6 vs 4 days; Poisson rate ratio 1.61, 95% CI 1.12 to 2.10, P<0.001), and higher hospitalization cost (adjusted B 10.7, 95% CI 9.5 to 12.0, P<0.001). Among those discharged home during the index admission, there was no difference in 180-day major morbidity or mortality between groups.Conclusion For pVCF patients, early inpatient spinal intervention was significantly associated with higher odds of discharge to home without increased adverse events.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA"
      ],
      "name": "Matthew K McIntyre"
    },
    {
      "affiliations": [
        "National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA",
        "Department of Neurology, University of Maryland Medical Center, Baltimore, Maryland, USA"
      ],
      "name": "Huanwen Chen"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Maryland Medical Center, Baltimore, Maryland, USA"
      ],
      "name": "Dheeraj Gandhi"
    },
    {
      "affiliations": [
        "Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA"
      ],
      "name": "Ajay Malhotra"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, WVU Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA"
      ],
      "name": "Dhairya A Lakhani"
    },
    {
      "affiliations": [
        "Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA"
      ],
      "name": "Jesse J Liu"
    },
    {
      "affiliations": [
        "Department of Interventional Radiology, Oregon Health & Science University, Portland, Oregon, USA"
      ],
      "name": "Marco Colasurdo"
    }
  ],
  "title": "Inpatient spinal intervention is associated with improved outcomes following thoracolumbar pathologic compression fractures: a national retrospective study",
  "uid": "2631548d-67b1-5563-a725-c26e4a3bca14"
}