Vertebroplasty and kyphoplasty in the USA from 2004 to 2017: national inpatient trends, regional variations, associated diagnoses, and outcomes

Abstract

BackgroundTo explore the national inpatient trends, regional variations, associated diagnoses, and outcomes of vertebral augmentation (vertebroplasty and kyphoplasty) in the USA from 2004 to 2017.MethodsData from the National Inpatient Sample were used to study hospitalization records for percutaneous vertebroplasty and kyphoplasty. Longitudinal projections of trends and outcomes, including mortality, post-procedural complications, length of stay, disposition, and total hospital charges were analyzed.ResultsFollowing a period of decreased utilization from 2008 to 2012, hospitalizations for vertebroplasty and kyphoplasty plateaued after 2013. Total hospital charges and overall financial burden of hospitalizations for vertebroplasty and kyphoplasty increased to a peak of $1.9 billion (range $1.7–$2.2 billion) in 2017. Overall, 8% of procedures were performed in patients with a history of malignancy. In multivariable modeling, lung cancer (adjusted OR (aOR) 2.6 (range 1.4–5.1)) and prostate cancer (aOR 3.4 (range 1.2–9.4)) were associated with a higher risk of mortality. The New England region had the lowest frequency of routine disposition (14.1±1.1%) and the lowest average hospital charges ($47 885±$1351). In contrast, 34.0±0.8% had routine disposition in the West Central South region, and average hospital charges were as high as $99 836±$2259 in the Pacific region. The Mountain region had the lowest number of procedures (5365±272) and the highest mortality rate (1.2±0.3%).ConclusionNational inpatient trends of vertebroplasty and kyphoplasty utilization remained stable after a period of decline from 2008 to 2012, while the financial burden of hospitalizations increased. Despite recent improvements in outcomes, significant regional variations persisted across the USA.

Height restoration and sustainability using bilateral vertebral augmentation systems for vertebral compression fractures: a cadaveric study

“…As of 2017, approximately 5,000 VP and 19,000 BKP procedures were performed in the USA and registered in the National Inpatient Sample of Healthcare Cost and Utilization Project database [2]. These procedures have demonstrated effectiveness in pain reduction [3−5] and low complication rates [3,4].…”

Safety and prognosis of repeated vertebroplasty in the treatment of osteoporotic vertebral fractures

“…It is estimated that there are approximately 1.5 million new vertebral compression fractures in the United States each year (3). In 2017, the total economic burden of PVP and PKP in the United States was about $1.9 billion (4), and it has stabilized year by year. PVP is widely used in patients with OVFs, because it can quickly relieve the pain at the fracture site, increase the stiffness and strength of the fractured vertebral body, and keep the patient away from the hospital bed earlier and participate in rehabilitation exercises (5).…”

The Impact of Machine Learning on 2D/3D Registration for Image-Guided Interventions: A Systematic Review and Perspective

“…While minimally invasive approaches are generally considered safe and effective, the indirect visualization of surgical instruments relative to anatomical structures complicates spatial cognition and the more confined room for maneuvers requires precise command of the surgical instruments. It is well known that due to the aforementioned challenges, among others, outcomes after minimally invasive surgery are positively correlated with technical proficiency, experience, and procedural volume of the operator ( Birkmeyer et al, 2013 ; Pfandler et al, 2019 ; Hafezi-Nejad et al, 2020 ; Foley and Hsu, 2021 ). To mitigate the impact of experience on complication risk and outcomes, surgical navigation solutions that register specialized tools with 3D models of the anatomy using additional tracking hardware are now commercially available ( Mezger et al, 2013 ; Ewurum et al, 2018 ).…”