title: Mortality in the vertebroplasty population.
abstract: OBJECTIVE
  Vertebroplasty is an effective treatment for painful compression fractures refractory to conservative management. Because there are limited data regarding the survival characteristics of this patient population, we compared the survival of a treated with an untreated vertebral fracture cohort to determine whether vertebroplasty affects mortality rates.
  
  
  METHODS
  The survival of a treated cohort, comprising 524 vertebroplasty recipients with refractory osteoporotic vertebral compression fractures, was compared with a separate historical cohort of 589 subjects with fractures not treated by vertebroplasty who were identified from the Rochester Epidemiology Project. Mortality was compared between cohorts by using Cox proportional hazards models adjusting for age, sex, and Charlson indices of comorbidity. Mortality was also correlated with pre-, peri-, and postprocedural clinical metrics (eg, cement volume use, RDQ score, analog pain scales, frequency of narcotic use, and improvement in mobility) within the treated cohort.
  
  
  RESULTS
  Vertebroplasty recipients demonstrated 77% of the survival expected for individuals of similar age, ethnicity, and sex within the US population. Compared with individuals with both symptomatic and asymptomatic untreated vertebral fractures, vertebroplasty recipients retained a 17% greater mortality risk. However, compared with symptomatic untreated vertebral fractures, vertebroplasty recipients had no increased mortality following adjustment for differences in age, sex, and comorbidity (HR, 1.02; 95% CI, 0.82-1.25). In addition, no clinical metrics used to assess the efficacy of vertebroplasty were predictive of survival.
  
  
  CONCLUSIONS
  Vertebroplasty recipients have mortality rates similar to those of individuals with untreated symptomatic fractures but have worse mortality compared with those with asymptomatic vertebral fractures.
authors: Clinician Investigator Training Program, Department of Radiology, College of Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. mcdonald.robert@mayo.edu
authors: R J
authors: RJ
authors: McDonald
authors: S J
authors: SJ
authors: Achenbach
authors: E J
authors: EJ
authors: Atkinson
authors: L A
authors: LA
authors: Gray
authors: H J
authors: HJ
authors: Cloft
authors: L J
authors: LJ
authors: Melton
authors: D F
authors: DF
authors: Kallmes
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D050815:Fractures, Compression / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D010024:Osteoporosis / Q000401:mortality* / Q000628:therapy*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016103:Spinal Fractures / Q000401:mortality* / Q000628:therapy*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000401:mortality*