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

Vadim Goz, Steven M. Koehler, Natalia N. Egorova, Alan J. Moskowitz, Stephanie A. Guillerme, Andrew C. Hecht, Sheeraz A. Qureshi

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Background context: Vertebral compression fractures (VCFs) are a substantial health concern. Kyphoplasty (KP) and vertebroplasty (VP) are vertebral augmentation procedures (VAPs) used to treat VCFs. Purpose: To compare VP and KP patient demographics and evaluate inpatient and outpatient utilization trends. Study design: Retrospective analysis of patient demographics, and inpatient and outpatient utilization trends, from California, New York, and Florida inpatient and ambulatory discharge databases. Methods: Hospitalizations 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 Revision diagnosis codes for pathologic, dorsal, and lumbar fracture of vertebrae were cross-referenced with ICD-9 procedure codes and Current Procedural Terminology codes to select the population. Patients younger than 40 years or those who underwent both procedures were excluded. Results: The 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). Conclusions: Vertebral 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.

Original languageEnglish (US)
Pages (from-to)737-744
Number of pages8
JournalSpine Journal
Volume11
Issue number8
DOIs
StatePublished - Aug 2011
Externally publishedYes

Keywords

  • Epidemiology
  • Kyphoplasty
  • Utilization
  • Vertebral compression fracture
  • Vertebroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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