SpineNational trends in vertebral augmentation procedures for the treatment of vertebral compression fractures
Introduction
Vertebral compression fractures represent a tremendous health care problem [4], [7], [9]. Kyphoplasty and vertebroplasty are 2 minimally invasive VAPs (together, will be abbreviated as VAPs) developed for the management of symptomatic VCFs [3], [5], [8].
Vertebral augmentation procedures have been gaining popularity in the treatment of symptomatic VCFs from osteoporotic or neoplastic etiology. The goal of this study was to examine patient demographics and outcomes for kyphoplasty or vertebroplasty on the basis of a large unselected sampling of US clinical practice that represents an unbiased cross-section across the entire country in a single year.
Section snippets
Methods
We used the NIS database, a nationwide database of hospital inpatient stays that represents the largest all-payer inpatient care database [2]. The NIS database contains data from approximately 8 million annual discharges from 1004 hospitals in 37 states [2]. We analyzed data collected from 1993 through 2004 to determine general trends in pathologic VCFs. Patients with pathologic VCFs who were treated with VAPs were identified using the ICD-9 diagnostic code (ICD-9—pathologic vertebral fracture,
Pathologic fractures
For the 11-year period from 1993 to 2004, there was a continued increase in the number of hospitalizations for pathologic vertebral fractures (16.9-18.9/100 000) (Fig. 1A). Even more dramatic was the increase in the number of VAPs performed for the same period, increasing from 182 in 1993 to 23 691 in 2004 (Fig. 1B). The rapid rise in the number of VAPs performed is even more dramatic (182-23 691; 12 900% increase) (Fig. 1B) and clearly outpaces the rise in other major procedures for the same
Discussion
Both vertebroplasty and kyphoplasty are indicated for progressive painful VCFs in the absence of neurologic signs[5], [6], [10]. The rapid rise in the number of VAPs (12 900% increase) performed from 1993 to 2004 outpaces the rate of increase for other major orthopedic procedures (Table 1); yet, only 42% of pathologic VCFs are being treated, leaving enormous room for continued growth.
In general, women account for 80% of the patients with osteoporosis and undergo a rapid loss of bone after
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Cited by (50)
Cost-effectiveness studies of vertebral augmentation for osteoporotic vertebral fractures: a systematic review
2022, Spine JournalCitation Excerpt :Given the expanding population of the elderly, increasing prevalence of osteoporotic disease and consequent health care and homecare burden [15,17,18], cost-effective treatment strategies are needed. Vertebral augmentation (VA) procedures such as vertebroplasty (VP) and balloon kyphoplasty (BK) are procedures increasingly being used to stabilize vertebral fractures, relieve pain, allow for more rapid mobilization and return to baseline function [19,20]. Both VP and KP consists of percutaneous bone cement injections into the fractured vertebral body.
Trends of utilization and physician payments for vertebroplasty and kyphoplasty procedures by physician specialty and practice setting: 2010 to 2018
2020, Spine JournalCitation Excerpt :Compression fractures are becoming increasingly common with the aging population. Consequently, the cost burden is high, with treatment in the United States costing approximately $5 billion annually [2-4]. Minimally invasive vertebral augmentation procedures are commonly performed for the treatment of pain related to vertebral body compression fractures.
Vertebroplasty and Kyphoplasty
2020, Image-Guided Interventions: Expert Radiology Series, Third EditionDischarge to Inpatient Care Facility After Vertebroplasty/Kyphoplasty: Incidence, Risk Factors, and Postdischarge Outcomes
2018, World NeurosurgeryCitation Excerpt :Unfortunately, there are limited studies looking at discharge destination, making it difficult to know whether this estimate is representative of all hospitals. One study in 2009, using the National Inpatient Sample (NIS) database, found that the final discharge disposition, home versus institution, was 50:50 for vertebroplasty and 77:23 for kyphoplasty.11 This estimate is slightly greater than our findings and may be attributed to a difference in the database collection methods, with the NSQIP and NIS having a different sample of hospitals.