Vertebral Augmentation for Spinal Fractures

Vertebral Augmentation for Spinal Fractures

Medical management of vertebral compression fractures costs patients and healthcare systems nearly $14 billion annually, according to recent estimates. Percutaneous vertebroplasty and balloon kyphoplasty procedures are being used increasingly for the treatment of these osteoporotic fractures, but the effectiveness and safety of these options are unclear, especially with regard to long-term survival. “Recently, there have been concerns about whether healthcare funding agencies should support these vertebral augmentation procedures as treatment modalities,” says Richard L. Skolasky, ScD. “Evaluating the role of these surgeries on survival, complications, and other parameters may help determine optimal treatment methods.” New Research on Vertebral Augmentation Dr. Skolasky and colleagues had a study published in the Journal of Bone & Joint Surgery that compared various aspects of the management of 69,000 Medicare patients in whom new vertebral compression fractures were treated with vertebroplasty, kyphoplasty, or non-operative modalities. The investigators examined differences in survival at 6 months, 1 year, 2 years, and 3 years in addition to complications, length of hospital stay, charges, 30-day readmission rates, and repeat procedures. According to the results, the overall survival rate for the entire study population was 77.8% at 1 year and 49.6% at 3 years. The kyphoplasty group had the highest survival rates at 1 and 3 years. Patients treated without surgery were hospitalized on average about 8 days longer than patients treated with surgery. However, total charges for kyphoplasty and vertebroplasty were $12,032 and $7,805 more than for non-operative treatment. There was no statistically significant difference in post-operative infections and neurologic complications between surgical and non-surgical patients. Surgically treated patients were less likely to be diagnosed with pneumonia or...

Conference Highlights: 2010 Society of Interventional Radiology Meeting

The Society of Interventional Radiology held its 2010 annual meeting from March 13 to 18 in Tampa, Florida. The features below highlight some of the news emerging from the meeting. For more information on these items and other research that was presented, go to » Preventing Strokes During Carotid Artery Stenting » Abnormal ABI Indicative of Cardiovascular Events » Vertebroplasty Relieves Pain for Osteoporotic VCFs Preventing Strokes During Carotid Artery Stenting The Particulars:Until recently, most carotid artery stenting procedures have been performed with filters in order to remove debris. The FDA has cleared a proximal cerebral protection device (Mo.Ma, Invatec) for use during carotid artery stenting. It suspends blood flow and prevents debris from traveling to the brain. Data Breakdown:Investigators evaluated the safety and effectiveness of the proximal cerebral protection device in 262 patients with carotid artery disease considered high risk. The 30-day major adverse cardiac and cerebrovascular events rate was 2.7%, a finding below the performance goal of 13% set before the start of the study. The major stroke rate was 0.9% through to the end of the trial; the death rate was also 0.9%. Take Home Pearls: Use of a proximal cerebral protection device may be able to prevent strokes during carotid stenting procedures. Results add to the body of data to support stenting as an alternative to surgery. Abnormal ABI Indicative of Cardiovascular Events [back to top] The Particulars:The ankle-brachial index (ABI) test is a noninvasive blood pressure reading in the ankle used to screen for peripheral artery disease (PAD). The ABI may provide another way to identify cardiovascular risks in older patients not considered...