We aimed to investigate the association between preoperative body mass index (BMI) and postoperative long-term mortality in patients who underwent a vertebroplasty. We retrospectively enrolled patients with a vertebral compression fracture who underwent a vertebroplasty between May 2013 and June 2020 in a medical center in Taiwan. The survival status of the study sample was confirmed by the end of March 2021. Cox-proportional hazard models were conducted to examine the effects of being overweight/obese (≥25 kg/m² vs. <25 kg/m²) and BMI (as a continuous variable) on all-cause mortality after adjusting for age, sex, history of smoking, diabetes, hypertension, chronic kidney disease, and osteoporosis. A total of 164 patients were analyzed (mean age 75.8 ± 9.3 years, male 25.6%, mean BMI 24.0 ± 4.1 kg/m²) after a median follow-up of 785 days. Compared with a BMI < 25 kg/m², a BMI ≥ 25 kg/m² was associated with a significantly lower risk of all-cause mortality (HR 0.297, 95% CI 0.101 to 0.878, p = 0.028). These findings were consistent when BMI was examined as a continuous variable (HR 0.874, 95% CI 0.773 to 0.988, p = 0.031). A low BMI (<22 kg/m²) should be considered as a risk factor for postoperative long-term mortality in this ageing population.

Introduction: Oswestry Disability Index (ODI) and EuroQol-5D (EQ-5D) have been widely used to assess general health quality and function in clinical studies of patients with vertebral fractures. We aimed to investigate the associations of preoperative ODI and EQ-5D with long-term mortality in patients undergoing percutaneous vertebroplasty.Material and methods: We retrospectively identified adult patients who had a single-level vertebral compression fracture and received percutaneous vertebroplasty between 2013 and 2020. Patients with traumatic fractures, burst fractures, and pathologic fractures, as well as those who had missing information on preoperative assessment of ODI and EQ-5D, were excluded. Survival status of the study patients was confirmed at the end of March 2021. The associations of preoperative ODI and EQ-5D with all-cause mortality were examined using Cox-proportional hazard models.Results: A total of 167 patients were analyzed (mean age 75.8 ± 9.3 years, 25.7% male). There were 28 patients who died during a median follow-up duration of 2.1 years (63.6 per 1000 patient-years). Preoperative ODI was significantly associated with all-cause mortality after vertebroplasty (HR 1.049, 95% CI 1.008 to 1.092, p=0.018). In contrast, preoperative EQ-5D was independently associated with a lower risk of all-cause mortality after the surgery (HR 0.202, 95% CI 0.043 to 0.936, p=0.041).Conclusions: Preoperative assessment of ODI (HR 1.049, 95% CI 1.008 to 1.092) and EQ-5D (HR 0.202, 95% CI 0.043 to 0.936) may help determine postoperative long-term mortality risk in this aging surgical population.

Background/Objectives: Intraoperative robotic hip-knee-ankle angle (HKA) measurements are obtained with the patient supine under operative conditions and may not directly represent postoperative standing weight-bearing alignment. This study quantified the correspondence and systematic differences between intraoperative ROSA HKA and standing radiographic HKA after robotic-assisted total knee arthroplasty. Methods: This retrospective single-center study included 208 knees from 178 consecutive patients, including 30 bilateral patients. The primary comparison was post-trial-component intraoperative ROSA HKA versus postoperative standing radiographic HKA; the secondary comparison was pre-cut intraoperative ROSA HKA versus preoperative standing radiographic HKA. Patient-cluster bootstrap confidence intervals used 10,000 resamples. Agreement was evaluated using Bland–Altman analysis, absolute-agreement ICC(A,1), and weighted kappa; Spearman ρ described association. Results: For the primary comparison, mean bias (ROSA minus radiographic HKA) was −1.75° (95% CI −2.08 to −1.43°), conventional limits of agreement were −6.36° to 2.85°, and ICC(A,1) was 0.472 (95% CI 0.379 to 0.557). Differences were within 3° in 70.2% of knees and exceeded 3° in 29.8%; proportional bias was present (slope −0.569, p < 0.001). The secondary comparison showed bias 0.97° and ICC(A,1) 0.956. Exact femoral and tibial size agreement was 42.3% and 80.8%, respectively. The standardized surgeon-entered 10 mm starting value was retained in 57.7% of knees. These systematic and angle-dependent differences may partly reflect the differing loading, positioning, and measurement conditions between the intraoperative trial construct and postoperative standing radiography. Conclusions: Post-trial-component ROSA HKA showed systematic and angle-dependent differences from postoperative standing HKA and should not be considered interchangeable with, or a fixed patient-level predictor of, postoperative standing alignment.

Purpose: Albumin levels have demonstrated superior predictive value for surgical outcomes across a variety of surgeries. However, their effect on long-term survival after vertebroplasty for vertebral compression fracture has not yet been well studied. This study aims to investigate the relationship between preoperative albumin levels and long-term survival in patients who underwent percutaneous vertebroplasty for vertebral compression fractures. Materials and methods: We enrolled patients who underwent vertebroplasty for vertebral compression fracture between the period of May 1, 2013 to June 30, 2020 in a single medical center. Patients who were diagnosed with a pathologic compression fracture, underwent additional spinal instrumentation during the same surgery, and those without data regarding their bone mineral density (BMD) were excluded. Cox proportional hazard models were conducted to examine the effects of hypoalbuminemia (<3.5 g/dL) on all-cause mortality after adjusting for age, gender, body mass index, smoking, diabetes, hypertension, chronic kidney disease (CKD), osteoporosis. Results: A total of 145 patients were analyzed, and the median follow-up period was 2.12 (interquartile range 1.51–3.28) years (mean follow-up 2.65 [SD 1.78] years). Compared with normal albumin levels, patients with hypoalbuminemia were found to be independently associated with a higher risk of all-cause mortality (hazard ratio 3.154, p = 0.014). These findings remained significant when albumin was examined as a continuous variable (hazard ratio 0.242, p = 0.001) and even after multivariate adjustment as well (hazard ratio 0.192, p = 0.004). Conclusion: Hypoalbuminemia was associated with all-cause mortality among patients who underwent vertebroplasty for vertebral compression fractures. Our findings highlighted the impact of nutritional status on long-term mortality in an elderly surgical population.