Clinical Improvement and Cost-effectiveness of CT-guided Radiofrequency Sacroplasty (RFS) and Cement Sacroplasty (CSP) - a Prospective Randomised Comparison of Methods Cement Augmentation in Insufficiency Fractures of the Sacral Bone

被引：10

作者：

Andresen, Reimer ^{[1
,2
,3
]}

Radmer, Sebastian ^{[4
]}

Andresen, Julian Ramin ^{[5
]}

Wollny, Mathias ^{[6
]}

Nissen, Urs ^{[7
,8
,9
]}

Schober, Hans-Christof ^{[10
]}

机构：

[1] Univ Kiel, Acad Teaching Hosp, Westkuestenklinikum Heide, Inst Diagnost & Intervent Radiol Neuroradiol, Esmarchstr 50, D-25746 Heide, Germany

[2] Univ Lubeck, Acad Teaching Hosp, Westkuestenklinikum Heide, Inst Diagnost & Intervent Radiol Neuroradiol, Esmarchstr 50, D-25746 Heide, Germany

[3] Univ Hamburg, Acad Teaching Hosp, Westkuestenklinikum Heide, Inst Diagnost & Intervent Radiol Neuroradiol, Esmarchstr 50, D-25746 Heide, Germany

[4] Ctr Orthopaed, Berlin, Germany

[5] Sigmund Freud Univ, Sch Med, Vienna, Austria

[6] Medimbursement, Tarmstedt, Austria

[7] Univ Kiel, Acad Teaching Hosp, Westkuestenklinikum Heide, Dept Neurosurg & Spine Surg, Heide, Austria

[8] Univ Lubeck, Acad Teaching Hosp, Westkuestenklinikum Heide, Dept Neurosurg & Spine Surg, Heide, Austria

[9] Univ Hamburg, Acad Teaching Hosp, Westkuestenklinikum Heide, Dept Neurosurg & Spine Surg, Heide, Austria

[10] Univ Rostock, Acad Teaching Hosp, Municipal Hosp Suedstadt Rostock, Dept Internal Med 1, Rostock, Germany

来源：

ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE | 2019年 / 157卷 / 05期

关键词：

insufficiency fracture; sacrum; radiofrequency sacroplasty; pain therapy; cement sacroplasty; PERCUTANEOUS SACROPLASTY; BALLOON SACROPLASTY; FRAGILITY FRACTURES; CLASSIFICATION; KYPHOPLASTY; DIAGNOSIS; REVENUE; CONTEXT; PAIN;

D O I：

10.1055/a-0815-5073

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Introduction The objective of this study was a comparative analysis of cement augmentation by means of RFS and CSP with regard to outcome and cost-effectiveness. Patients and Methods CT-guided cement augmentation was performed on 100 patients with a total of 168 non-dislocated insufficiency fractures, 50 patients being treated with RFS and 50 patients with CSP. Leakages were detected by CT. Pain intensity was determined on a VAS before and after the intervention. The patients' self-sufficiency was assessed using the Barthel index. Patients were asked about any complications and their level of satisfaction. Costs incurred for carrying out the procedure were compared with the respective reimbursements received. Results Both procedures were technically fully feasible. No leakages were found in the RFS group, as opposed to 8.1% asymptomatic leakages in the CSP group. The mean value for pain before intervention was 8.8 in the RFS group and 8.7 in the CSP group. On the second postoperative day, there was a significant pain reduction with a value of 2.4 for both groups, which remained more or less constant over the follow-up period. The Barthel index increased significantly from an average of 30 before the intervention to 80 on the fourth postoperative day and 70 after 24 months. No differences were found between the two procedures with regard to pain, improvement in functional status and satisfaction. Taking into account the state-wide base rate used for calculating reimbursement, 3,834.75 (sic) remained for RFS and 5,084.32 (sic) for CSP. Conclusion RFS and CSP are minimally invasive procedures that achieve equally good and sustained pain reduction, leading to markedly improved self-sufficiency of the patients. With regard to possible cement leakages, RFS is the safer method. A profit can be generated with both techniques.

引用

页码：524 / 532

页数：9

共 42 条

[1] Combined pubic rami and sacral osteoporotic fractures: A prospective study [J].