Kyphoplasty and vertebroplasty: trends in use in ambulatory and inpatient settings

Publication year: 2011
Source: The Spine Journal, Available online 8 September 2011
Vadim Goz, Steven M. Koehler, Natalia N. Egorova, Alan J. Moskowitz, Stephanie A. Guillerme, …
Background contextVertebral compression fractures (VCFs) are a substantial health concern. Kyphoplasty (KP) and vertebroplasty (VP) are vertebral augmentation procedures (VAPs) used to treat VCFs.PurposeTo compare VP and KP patient demographics and evaluate inpatient and outpatient utilization trends.Study designRetrospective analysis of patient demographics, and inpatient and outpatient utilization trends, from California, New York, and Florida inpatient and ambulatory discharge databases.MethodsHospitalizations for VP and KP were identified from California, New York, and Florida inpatient and ambulatory discharge databases from 2005 to 2008.International Classification of Diseases, Ninth Revisiondiagnosis codes for pathologic, dorsal, and lumbar fracture of vertebrae were cross-referenced with ICD-9 procedure codes andCurrent Procedural Terminologycodes to select the population. Patients younger than 40 years or those who underwent both procedures were excluded.ResultsThe final population contained 61,851 VAPs (35,805 KPs and 26,046 VPs). Kyphoplasty showed increased inpatient and outpatient utilization. Vertebroplasty utilization remained at a low level of 6/100,000 capita. Kyphoplasty patients had more comorbidities than VP patients. In Florida in 2008, radiologists performed most VPs (52.3%) and orthopedists performed the most KPs (35.45%). Postoperative complication rates were significantly different; 0.79% of KPs had cardiac complications versus 0.57% of VPs (p=.0073). Respiratory complications occurred in 0.83% of KPs and 0.49% of VPs (p<.0001).ConclusionsVertebral augmentation procedures have seen a continued increase in use from 2004 to 2008. Use of KP significantly outpaces the use of VP. Reasons for the increasing utilization of KP likely include financial incentives, the specialty performing KP, perceived safety, and effectiveness of vertebral height restoration. Conflicting evidence regarding which procedure is safer warrants further evaluation.

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Júlio Leonardo B. Pereira


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