Comparison of vertebroplasty and kyphoplasty for osteoporotic spinal fractures: An observational study using administrative data from England

Purpose: To investigate the variation in the use of, and outcomes for, vertebroplasty (VP) and balloon kyphoplasty (BKP) techniques for osteoporotic spinal fracture for patients operated on within the National Health Service in England. Methods This was an observational analysis of administrative data. Data were extracted from the Hospital Episodes Statistics database for the period 1st April 2011 to 31st March 2018 for all VP and BKP procedures. Patients aged < 19 years, with metastatic carcinoma and undergoing other decompression procedures were excluded. The primary outcome was repeat spinal surgery within one year. Secondary outcomes were 30-day emergency readmission, death within one year, extended hospital stay, post-procedural pain within 30 days and post-procedural haemorrhage or infection within 30 days. Multilevel, multivariable logistic regression was used to adjust for covariates. Results Data were available for 5,792 VP and 3,136 BKP patients operated on at 96 hospital trusts. In the 63 trusts that conducted more than 20 procedures during the study period, the proportion of procedures conducted as BKP varied from 0–100%. There was no difference in any of the outcomes between VP and BKP patients or between trusts performing ≥ 70% and ≤ 30% of procedures as BKP. Conclusions There is no evidence that VP is associated with poorer outcomes than VP. The greater costs of performing BKP may be hard to justify as healthcare budgets continue to be put under pressure as they recover from the coronavirus pandemic.