European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Comparative Study
Comparison of inpatient treatment costs after balloon kyphoplasty and non-surgical treatment of vertebral body compression fractures.
We performed an analysis of following costs after primary conservative or operative treatment with balloon kyphoplasty (BKP) in osteoporotic vertebral fractures. Patients with primary osteoporotic vertebral fractures treated with BKP or conservatively from discharge year 2002-2005 were retrospectively assessed regarding the following hospital treatment in any hospital in Austria from 2002 to 2006. A statistical record linkage between the hospital data and the mortality registry of Statistic Austria was performed. ⋯ The number of readmissions was 1.62 times higher (P = 0.039), the length of stay 1.09 times higher (P = 0.046) in the conservative group. No difference in the DRG scores were found (P = 0.11). In conclusion, patients with osteoporotic vertebral fractures showed in the following years after BKP fewer hospital readmissions and shorter hospital stays but no difference in DRG scores in comparison to conservatively treated patients.
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Comparative Study
Comparison of unipedicular and bipedicular kyphoplasty on the stiffness and biomechanical balance of compression fractured vertebrae.
Percutaneous kyphoplasty (PKP) has been used to treat osteoporotic vertebral compression fractures for over 10 years; however, clinically speaking it is still controversial as to whether the use of unipedicular PKP or bipedicular PKP is best. Our study aimed to compare the different effects of unipedicular PKP and bipedicular PKP on the stiffness of compression fractured vertebral bodies (VBs), as well as to assess how cement distribution affect the bilateral biomechanical balance of the VBs. During this study, 30 thoracic VBs were compressed, creating vertebral compression fracture models; then they were augmented by unipedicular (group A and B) PKP and bipedicular (group C) PKP. ⋯ Bipedicular PKP creates stiffness uniformly across both sides of the vertebrae, while unipedicular PKP, creates a biomechanical balance depending on the distribution of cement. If bone cement is augmented only on one side, the stiffness of non-augmented side will be significantly lower than the augmented side, which might lead to an imbalance of stress on the VB. However, when cement augmentation crosses the midline, stiffness of both sides increase comparatively and biomechanical balance is thus achieved.
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Comparative Study Clinical Trial
Validity of the 10-s step test: prospective study comparing it with the 10-s grip and release test and the 30-m walking test.
Cervical compressive myelopathy (CCM) is one of the common neurological disorders seen in the geriatric population. The 10-s Grip and Release ("G and R") Test and the 30-m Walking ("Walking") Test are widely known as quantifiable physical assessments for the severity of cervical myelopathy. We developed the 10-s Step ("Step") Test as another easily performable quantifiable measure for this. ⋯ Linear regression analyses showed that the results of the Step Test correlated with JOA scores to the same degree as the Walking Test results did, and to a greater degree than the G and R Test results did. Moreover, the results of the Step Test showed a significant degree of correlation with JOACMEQ-L. In view of these findings, our conclusion was that the easily performed Step Test is an useful test for assessing the severity of cervical myelopathy, especially for the lower limb dysfunction secondary to CCM.
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Comparative Study Clinical Trial
Adjacent-level degeneration after cervical disc arthroplasty versus fusion.
The principal objective of this study was to evaluate the incidence of adjacent-segment degeneration (ASD) in patients who underwent cervical disc arthroplasty (CDA) as compared with anterior cervical discectomy and fusion (ACDF). ⋯ Preservation of motion in the CDA patients was not associated with a reduction of the incidence of symptomatic adjacent-segment disease and there may be other factors that influence ASD.