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BioMed Research International
Volume 2016 (2016), Article ID 3623875, 9 pages
http://dx.doi.org/10.1155/2016/3623875
Research Article

Outcomes and National Trends for the Surgical Treatment of Lumbar Spine Trauma

1Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
2Department of Surgery, University of Arizona College of Medicine, Tucson, AZ 85724, USA
3Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
4Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
5Department of Neurosurgery, University of California Davis Medical Center, Sacramento, CA 95820, USA

Received 13 February 2016; Revised 21 May 2016; Accepted 22 May 2016

Academic Editor: Panagiotis Korovessis

Copyright © 2016 Doniel Drazin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Operative treatment of lumbar spine compression fractures includes fusion and/or cement augmentation. Our aim was to evaluate postoperative differences in patients treated surgically with fusion, vertebroplasty, or kyphoplasty. Methods. The Nationwide Inpatient Sample Database search for adult vertebral compression fracture patients treated 2004–2011 identified 102,316 surgical patients: 30.6% underwent spinal fusion, 17.1% underwent kyphoplasty, and 49.9% underwent vertebroplasty. Univariate analysis of patient and hospital characteristics, by treatment, was performed. Multivariable analysis was used to determine factors associated with mortality, nonroutine discharge, complications, and patient safety. Results. Average patient age: fusion (46.2), kyphoplasty (78.5), vertebroplasty (76.7) (). Gender, race, household income, hospital-specific characteristics, and insurance differences were found (). Leading comorbidities were hypertension, osteoporosis, and diabetes. Risks for higher mortality (OR 2.0: CI: 1.6–2.5), nonroutine discharge (OR 1.6, CI: 1.6–1.7), complications (OR 1.1, CI: 1.0–1.1), and safety related events (OR 1.1, CI: 1.0–1.1) rose consistently with increasing age, particularly among fusion patients. Preexisting comorbidities and longer in-hospital length of stay were associated with increased odds of nonroutine discharge, complications, and patient safety. Conclusions. Fusion patients had higher rates of poorer outcomes compared to vertebroplasty and kyphoplasty cohorts. Mortality, nonroutine discharge, complications, and adverse events increased consistently with older age.