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Resource Consumption and Remuneration Aspects in Navigated Screw Fixation Procedures with or without Additional Sacroplasty for Fragility Fractures of the Sacrum—A Prospective Clinical Study

Surgical treatment for sacral fragility fractures using navigation-assisted screw fixation (NSF) is a modern, technically demanding procedure. Additional sacroplasty (ASP) has been shown to provide only insignificant clinical benefits for patients. This investigation highlights procedural economic a...

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Autores principales: Balling, Horst, Holzapfel, Boris Michael, Böcker, Wolfgang, Arnholdt, Joerg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605172/
https://www.ncbi.nlm.nih.gov/pubmed/36294455
http://dx.doi.org/10.3390/jcm11206136
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author Balling, Horst
Holzapfel, Boris Michael
Böcker, Wolfgang
Arnholdt, Joerg
author_facet Balling, Horst
Holzapfel, Boris Michael
Böcker, Wolfgang
Arnholdt, Joerg
author_sort Balling, Horst
collection PubMed
description Surgical treatment for sacral fragility fractures using navigation-assisted screw fixation (NSF) is a modern, technically demanding procedure. Additional sacroplasty (ASP) has been shown to provide only insignificant clinical benefits for patients. This investigation highlights procedural economic aspects and evaluates results with regard to resource scarcity in order to be able to decide, whether ASP has a justification in NSF procedures beyond clinical aspects. From February 2011 to May 2017, all individuals with sacral fragility fractures surgically treated using 3D-fluoroscopy for NSF (n = 26) or NSF + ASP (n = 26) were enrolled. Outcome parameters were operative time, 3D-/2D-radiation dose, 2D-fluoroscopy time, material costs and reimbursement. In the two groups, a total of 52 individuals with 124 fragility fracture sites in sacral vertebrae I and II were surgically treated with similar numbers of screws inserted (p ≈ 0.679) requiring similar 3D- (p ≈ 0.546) and 2D-fluoroscopy radiation doses (p ≈ 0.236). In procedures with ASP, average 2D-fluoroscopy time (46.6 s vs. 32.7 s, p ≈ 0.004), and mean surgical duration (119 min vs. 96 min, p ≈ 0.011) were significantly longer. Mean implant costs (EUR 668.68 vs. EUR 204.34, p < 0.001), and reimbursement (EUR 8416.01 vs. EUR 6584.49, p ≈ 0.006) were significantly higher. Although comparison of costs and reimbursements indicated a positive financial balance, profitability was not confirmed, because financial expense for extended operative time prevented an economic advantage of procedures with ASP in this investigation. A formula was developed based on presented study data to allow similar economical decisions in other health care systems or institutions with differing resource costs.
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spelling pubmed-96051722022-10-27 Resource Consumption and Remuneration Aspects in Navigated Screw Fixation Procedures with or without Additional Sacroplasty for Fragility Fractures of the Sacrum—A Prospective Clinical Study Balling, Horst Holzapfel, Boris Michael Böcker, Wolfgang Arnholdt, Joerg J Clin Med Perspective Surgical treatment for sacral fragility fractures using navigation-assisted screw fixation (NSF) is a modern, technically demanding procedure. Additional sacroplasty (ASP) has been shown to provide only insignificant clinical benefits for patients. This investigation highlights procedural economic aspects and evaluates results with regard to resource scarcity in order to be able to decide, whether ASP has a justification in NSF procedures beyond clinical aspects. From February 2011 to May 2017, all individuals with sacral fragility fractures surgically treated using 3D-fluoroscopy for NSF (n = 26) or NSF + ASP (n = 26) were enrolled. Outcome parameters were operative time, 3D-/2D-radiation dose, 2D-fluoroscopy time, material costs and reimbursement. In the two groups, a total of 52 individuals with 124 fragility fracture sites in sacral vertebrae I and II were surgically treated with similar numbers of screws inserted (p ≈ 0.679) requiring similar 3D- (p ≈ 0.546) and 2D-fluoroscopy radiation doses (p ≈ 0.236). In procedures with ASP, average 2D-fluoroscopy time (46.6 s vs. 32.7 s, p ≈ 0.004), and mean surgical duration (119 min vs. 96 min, p ≈ 0.011) were significantly longer. Mean implant costs (EUR 668.68 vs. EUR 204.34, p < 0.001), and reimbursement (EUR 8416.01 vs. EUR 6584.49, p ≈ 0.006) were significantly higher. Although comparison of costs and reimbursements indicated a positive financial balance, profitability was not confirmed, because financial expense for extended operative time prevented an economic advantage of procedures with ASP in this investigation. A formula was developed based on presented study data to allow similar economical decisions in other health care systems or institutions with differing resource costs. MDPI 2022-10-18 /pmc/articles/PMC9605172/ /pubmed/36294455 http://dx.doi.org/10.3390/jcm11206136 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Perspective
Balling, Horst
Holzapfel, Boris Michael
Böcker, Wolfgang
Arnholdt, Joerg
Resource Consumption and Remuneration Aspects in Navigated Screw Fixation Procedures with or without Additional Sacroplasty for Fragility Fractures of the Sacrum—A Prospective Clinical Study
title Resource Consumption and Remuneration Aspects in Navigated Screw Fixation Procedures with or without Additional Sacroplasty for Fragility Fractures of the Sacrum—A Prospective Clinical Study
title_full Resource Consumption and Remuneration Aspects in Navigated Screw Fixation Procedures with or without Additional Sacroplasty for Fragility Fractures of the Sacrum—A Prospective Clinical Study
title_fullStr Resource Consumption and Remuneration Aspects in Navigated Screw Fixation Procedures with or without Additional Sacroplasty for Fragility Fractures of the Sacrum—A Prospective Clinical Study
title_full_unstemmed Resource Consumption and Remuneration Aspects in Navigated Screw Fixation Procedures with or without Additional Sacroplasty for Fragility Fractures of the Sacrum—A Prospective Clinical Study
title_short Resource Consumption and Remuneration Aspects in Navigated Screw Fixation Procedures with or without Additional Sacroplasty for Fragility Fractures of the Sacrum—A Prospective Clinical Study
title_sort resource consumption and remuneration aspects in navigated screw fixation procedures with or without additional sacroplasty for fragility fractures of the sacrum—a prospective clinical study
topic Perspective
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605172/
https://www.ncbi.nlm.nih.gov/pubmed/36294455
http://dx.doi.org/10.3390/jcm11206136
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