A comparative study on percutaneous vertebroplasty for osteoporotic vertebral compression fractures under day surgery...

To compare the clinical efficacy, safety and health economic differences of percutaneous vertebroplasty for osteoporotic vertebral compression fractures (OVCF) under the day surgery and conventional inpatient management modes.

A retrospective cohort study was conducted. A total of 168 OVCF patients who underwent percutaneous vertebroplasty from March 2023 to December 2024 were included, with 86 cases in the day surgery group, who completed admission, surgery, postoperative observation and discharge within one working day, and 82 cases in the inpatient group, who stayed overnight after surgery or had a total hospital stay of more than 24 h. The grouping was based on: patients who met the hospital's day surgery admission criteria and had perfect home care conditions after receiving standardized outpatient evaluation, anesthesia evaluation and perioperative risk stratification were included in the day surgery pathway; those who adopted the conventional inpatient process due to comorbidities requiring extended observation, long preoperative evaluation time, insufficient home care or patient's wishes were included in the inpatient group. The visual analogue scale (VAS) score, Oswestry disability index (ODI), analgesic medication use score and mobility score were compared between the two groups before surgery, 1 week after surgery and at the last follow-up. Meanwhile, the direct medical costs, patient satisfaction, surgery-related indicators and perioperative complications were compared between the two groups.

There were no statistically significant differences in baseline data between the two groups (all P > 0.05). The VAS score, ODI, analgesic medication use score and mobility score of the day surgery group at 1 week after surgery and at the last follow-up were significantly improved compared with those before surgery (all P < 0.01). There were no statistically significant differences in VAS score, ODI, analgesic medication use score and mobility score between the two groups at 1 week after surgery and at the last follow-up (all P > 0.05). The total hospital stay of the day surgery group was shorter than that of the inpatient group, the direct medical cost was lower than that of the inpatient group, and the patient satisfaction was higher than that of the inpatient group, with statistically significant differences (all P < 0.01). There were no statistically significant differences in intraoperative blood loss, bone cement injection volume and postoperative complication rate between the two groups (all P > 0.05).

For strictly screened OVCF patients, percutaneous vertebroplasty under the day surgery mode can achieve short-term and early medium-term efficacy equivalent to that of inpatient management, without increasing the risk of perioperative complications, and can significantly shorten the hospital stay, reduce direct medical costs and improve patient satisfaction.