Cement augmentation of XXXX : survivorship analysis.

@entity1 @entity174 @entity5 @entity3814 @entity615 @entity158 @entity204
STUDY DESIGN: Retrospective cohort. OBJECTIVE: To compare survivorship after cement augmentation of @entity3814 (OVCFs) with traditional @entity158 management and bracing. SUMMARY OF BACKGROUND DATA: OVCFs can cause debilitating @entity158 and functional decline necessitating prolonged bed rest and high-dose narcotics. Vertebroplasty and kyphoplasty are cement augmentation procedures used to control @entity158 and restore function in @entity1 with OVCF's that are refractory to conservative treatment. Early mobilization is associated with improved survival after other @entity174 in elderly @entity1 . METHODS: A university hospital database was used to identify all @entity1 treated with primary diagnosis of OVCF between 1993 and 2006. Chart review and imaging studies were used to confirm demographics, comorbidities, diagnosis, and treatment. Survival time was determined using hospital data, national @entity204 indices and @entity1 follow-up. Exact Fisher tests, Mann-Whitney tests, and proportional hazards regression models with Kaplan-Meier plots compared @entity1 treated with cement augmentation with controls treated with @entity158 management and bracing. @entity1 with high-energy trauma, @entity5 or age more than 60 years were excluded. RESULTS: Within the past 12 years, 46 @entity1 treated with cement augmentation and 129 matched controls met inclusion criteria. They did not differ with respect to age, sex, and comorbidities. A significant survival advantage was found after cement augmentation compared with controls (P < 0.001; log rank), regardless of comorbidities, age, or the number of @entity174 diagnosed at the start date (P = 0.565). Controlling simultaneously for covariates, the estimated hazard ratio associated with cementation was 0.10 (95% confidence interval [CI] = 0.02-0.43; P = 0.002) for year 1, 0.15 (95% CI = 0.02-1.12; P = 0.064) for year 2, and 0.95 (95% CI = 0.32-2.79; P = 0.919) for subsequent follow-up. The number of OVCFs at the start time of treatment did not affect survival benefit of cementation (P = 0.44). CONCLUSION: Cement augmentation of refractory OVCF improves survival for up to 2 years when compared with conservative @entity158 management with bed rest, narcotics, and extension bracing, regardless of age, sex, and number of @entity174 or comorbidities. Therefore, aggressive management should be considered for refractory OVCFs with @entity615 .
