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Kyphoplasty and vertebroplasty: trends in use in ambulatory and inpatient settings.
Spine J. 2011 Aug; 11(8):737-44.SJ

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.

Authors+Show Affiliations

Leni and Peter W. May Department of Orthopaedic Surgery, The Mount Sinai Medical Center, 5 East 98th St, 9th Floor, New York, NY 10029, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21862416

Citation

Goz, Vadim, et al. "Kyphoplasty and Vertebroplasty: Trends in Use in Ambulatory and Inpatient Settings." The Spine Journal : Official Journal of the North American Spine Society, vol. 11, no. 8, 2011, pp. 737-44.
Goz V, Koehler SM, Egorova NN, et al. Kyphoplasty and vertebroplasty: trends in use in ambulatory and inpatient settings. Spine J. 2011;11(8):737-44.
Goz, V., Koehler, S. M., Egorova, N. N., Moskowitz, A. J., Guillerme, S. A., Hecht, A. C., & Qureshi, S. A. (2011). Kyphoplasty and vertebroplasty: trends in use in ambulatory and inpatient settings. The Spine Journal : Official Journal of the North American Spine Society, 11(8), 737-44. https://doi.org/10.1016/j.spinee.2011.07.002
Goz V, et al. Kyphoplasty and Vertebroplasty: Trends in Use in Ambulatory and Inpatient Settings. Spine J. 2011;11(8):737-44. PubMed PMID: 21862416.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kyphoplasty and vertebroplasty: trends in use in ambulatory and inpatient settings. AU - Goz,Vadim, AU - Koehler,Steven M, AU - Egorova,Natalia N, AU - Moskowitz,Alan J, AU - Guillerme,Stephanie A, AU - Hecht,Andrew C, AU - Qureshi,Sheeraz A, Y1 - 2011/09/08/ PY - 2011/01/03/received PY - 2011/04/07/revised PY - 2011/07/01/accepted PY - 2011/8/25/entrez PY - 2011/8/25/pubmed PY - 2012/1/14/medline SP - 737 EP - 44 JF - The spine journal : official journal of the North American Spine Society JO - Spine J VL - 11 IS - 8 N2 - 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. SN - 1878-1632 UR - https://www.unboundmedicine.com/medline/citation/21862416/Kyphoplasty_and_vertebroplasty:_trends_in_use_in_ambulatory_and_inpatient_settings_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1529-9430(11)00474-8 DB - PRIME DP - Unbound Medicine ER -