LAUSR

INTRODUCTION Vertebral cement augmentation techniques are routinely employed to treat osteoporotic vertebral compression fractures (VCF). In the current study, we employed a state-level outpatient database to compare costs and post-operative outcomes between vertebroplasty and kyphoplasty. METHODS We queried the 2016 Florida State-Ambulatory Surgery Database of the Healthcare Cost and Utilization Project for patients undergoing thoraco-lumbar vertebroplasty or kyphoplasty for osteoporotic VCFs. Demographic and clinical characteristics, as well as post-operative outcomes were compared between the two groups. RESULTS A total of 105 patients (11.6%) who underwent vertebroplasty and 801 patients (88.4%) who underwent kyphoplasty were identified. Kyphoplasty patients were more likely to stay overnight or longer, with the p-value trending towards significance (kyphoplasty with >1-day stay: 7.4% vs. vertebroplasty with >1-day stay: 1.9%; p=0.086). Vertebroplasty patients had a significantly higher rate of home-routine discharge compared to kyphoplasty (97.1% (n=102) vs 94.1% (n=754); p<0.001). Undergoing kyphoplasty was also associated with higher index-admission costs ($40,706 vs. $18,965, p< 0.001) and higher readmission costs ($27,038 vs $11,341, p=0.046). The rates of 30- and 90-day readmissions was similar between the two groups (all p>0.05). The rates of 30-day, 90-day, and overall readmissions due to a new-onset fracture were also similar (all p>0.05). However, vertebroplasty had a higher rate of readmissions associated with a procedure within a year (21.9% (n=23) vs. 14.5% (n=116); p=0.047). CONCLUSION Our analyses from a state-level database of patients undergoing vertebroplasty and kyphoplasty for osteoporotic VCSs demonstrate similar postoperative-outcomes for the two procedures but a higher cost for kyphoplasty.