Inpatient Hospital and Post-Acute Care for Vertebral Fractures in Women

Burge, Russel; Puleo, Elaine; Gehlbach, Stephen H.; Worley, Dan; Klar, Janelle

doi:10.1046/j.1524-4733.2002.54126.x

Cited by 24 publications

(9 citation statements)

References 16 publications

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“…Although hip fractures account for most of the direct medical costs attributable to osteoporotic fractures, the estimated mean cost attributable to a clinical vertebral fracture is 30%e50% of the cost attributable to a hip fracture (223e225), and the total societal cost burden attributable to vertebral fracture is exceeded only by hip fracture. Moreover, a substantial proportion of those hospitalized for a vertebral fracture require post-acute care in a skilled nursing facility following the fracture [estimated to be 40% or more in the United States (226)]. In fact, clinical vertebral fractures may cause incremental health care utilization attributable to the fracture for 5 yr after their occurrence (225).…”

Section: Association With Health Care Costs and Utilizationmentioning

confidence: 99%

Epidemiology of Vertebral Fractures

Schousboe

2016

Journal of Clinical Densitometry

324

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Section: Association With Health Care Costs and Utilizationmentioning

confidence: 99%

Epidemiology of Vertebral Fractures

Schousboe

2016

Journal of Clinical Densitometry

324

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“…While there is growing literature examining the cost of vertebral and non-vertebral fractures, many of the studies estimate cost based on economic models instead of data from real-world practice settings [2,[14][15][16][17]. Other studies are confined to a specific gender or age cohort [12,14,18] or use data drawn from a single county in the US [4,19].…”

Section: Introductionmentioning

confidence: 99%

Direct healthcare costs of hip, vertebral, and non-hip, non-vertebral fractures

Shi¹,

Foley²,

Lenhart³

et al. 2009

Bone

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“…Some patients, however, remain unresponsive to conservative therapy. These patients have persistently painful osteoporotic VCFs which limit functional activities [5], impair quality of life [4] and increase healthcare costs [3].…”

Section: Introductionmentioning

confidence: 99%

Results, experience and technical points learnt with use of the SKy Bone Expander kyphoplasty system for osteoporotic vertebral compression fractures: a prospective study of 40 patients with a minimum of 12 months of follow-up

et al. 2007

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To describe our centre's results, experience and technical points learnt with the SKy Bone Expander System for osteoporotic vertebral compression fractures (VCFs). Forty consecutive patients with painful single level T12 or L1 osteoporotic VCF who had failed conservative management for more than 3 months had 40 single level SKy Bone Expander kyphoplasties performed. Using local anaesthesia with patients in a prone, hyper-lordotic position, a unilateral, percutaneous, intra-pedicular approach was employed. Once correctly positioned, the SKy Bone Expander was expanded, creating a void. It was subsequently contracted, removed and bone cement injected. Pre-kyphoplasty and 12-month post-kyphoplasty radiological and functional outcomes were recorded. Statistical analysis was by Wilcoxon Signed Ranks Test. Median percentage increase in anterior, middle and posterior vertebral body heights at 12-month post-operative was 51.25% [inter-quartile range (IQR) 17.21-93.22], 52.29% (IQR 26.50-126.17) and 9.84% (IQR 4.94-19.26) respectively, while median percentage decrease in kyphotic angle was 30.77% (IQR 17.06-46.61). There was no significant vertebral body correction loss at 12-month post-operative. Visual analogue score, North American Spine Society and Short Form-36 scores for physical functioning and bodily pain scores improved by medians of 5.0 (IQR 3.0-8.0), 1.45 (IQR 0.68-2.90), 20.5 (IQR 0.0-40.8) and 10.0 (IQR 0.0-20.0) respectively. All P-values were <0.001. There were eight adjacent/remote level VCFs, three cases of cement extravasation and one case of the SKy Bone Expander being unable to be contracted and withdrawn from the vertebral body. It was left in situ. This is the first reported incidence of such a complication. The SKy Bone Expander System appears to be a viable alternative to balloon tamp kyphoplasty. Important technical considerations include proper device positioning within the vertebral body before expansion, single use of devices, familiarity with salvage procedure and injection of bone cement under close image intensifier guidance to prevent cement extravasation.

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Inpatient Hospital and Post-Acute Care for Vertebral Fractures in Women

Abstract: Vertebral fractures are more expensive and resource-intensive than previously reported. Furthermore, total costs may be much greater when the components of post-acute care are fully captured.

Cited by 24 publications

References 16 publications

Epidemiology of Vertebral Fractures

Epidemiology of Vertebral Fractures

Direct healthcare costs of hip, vertebral, and non-hip, non-vertebral fractures

Results, experience and technical points learnt with use of the SKy Bone Expander kyphoplasty system for osteoporotic vertebral compression fractures: a prospective study of 40 patients with a minimum of 12 months of follow-up

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