Kyphoplasty

Percutaneous vertebroplasty
Intervention
Typical interventional suite setup for kyphoplasty
ICD-9-CM	81.65
MedlinePlus	007512
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Vertebroplasty and kyphoplasty are similar medical spinal procedures in which bone cement is injected through a small hole in the skin (percutaneously) into a fractured vertebra with the goal of relieving back pain caused by vertebral compression fractures. It was found not to be effective in treating osteoporosis-related compression fractures of the spine in the only two placebo controlled and randomized clinical trials that have been conducted. The people in both the experimental and placebo groups of the blinded study reported improvement in their pain, suggesting that the benefit noted in unblinded trials is related to the placebo effect.

The cost of vertebroplasty in Europe as of 2010 was ~2,500 Euro. As of 2010 in the United States, when done as an outpatient, vertebroplasty costs around 3300 USD while kyphoplasty costs around 8100 USD and when done as an inpatient vertebroplasty cost ~11,000 USD and kyphoplasty 16,000 USD.

The effectiveness of vertebroplasty is disputed. The only two randomized placebo controlled trials done as of 2014 found no benefit in those with osteoporosis-related fractures. The subjects in these trials had primarily non-acute fractures and prior to the release of the results they were considered the most ideal people to receive the procedure. After trial results were released vertebroplasty advocates pointed out that people with acute vertebral fractures were not investigated. A number of non-blinded trials suggested effectiveness, but the lack of blinding limits what can be concluded from the results and some have been criticized because of being funded by the manufacturer. One analysis has attributed the difference to selection bias.

Some have suggested that this procedure only be done in those with fractures less than 8 weeks old; however, analysis of the two blinded trials appear not to support the procedure even in this acute subgroup. Others consider the procedure only appropriate for those with other health problems making rest possibly detrimental, those with metastatic cancer as the cause of the spine fracture, or those who do not improve with conservative management.