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Original research
Analysis of vertebral augmentation practice patterns: a 2016 update
  1. Joshua A Hirsch1,
  2. Ronil V Chandra2,
  3. Vidsysagar Pampati3,
  4. John D Barr4,
  5. Allan L Brook5,
  6. Laxmaiah Manchikanti6
  1. 1Neuroendovascular Program and NeuroInterventional Spine Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Interventional Neuroradiology Service, Departments of Medicine and Surgery, Monash Imaging, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia
  3. 3Pain Management Center of Paducah, University of Louisville, Paducah, Kentucky, USA
  4. 4Departments of Radiology and Neurological Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
  5. 5Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
  6. 6Pain Management Center of Paducah, University of Louisville, Louisville, Kentucky, USA
  1. Correspondence to Dr J A Hirsch, Neuroendovascular Program and NeuroInterventional Spine Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; Hirsch{at}


Objective To evaluate procedure utilization patterns for vertebroplasty and kyphoplasty in the US Medicare population from 2004 to 2014.

Methods The analysis was performed using the Centers for Medicare and Medicaid Services database of specialty utilization files for the fee for service (FFS) Medicare population.

Results The FFS Medicare population increased by 28% with an annual increase of 2.5% from 2004 to 2014. Utilization of vertebroplasty procedures decreased by 63% with an average annual decrease of 9.5% from 2004 to 2014 per 100 000 FFS Medicare beneficiaries. During the same time period, kyphoplasty procedures decreased by a total of 10%, with an average annual decrease of 1.3%. For augmentation generally (combined vertebroplasty/kyphoplasty data) there was thus an overall decrease in the rate per 100 000 Medicare population of 32% from 2004 to 2014, with an average annual decrease of 4.8%. The majority of vertebroplasty procedures were performed by radiologists whereas the majority of kyphoplasties were performed by orthopedic surgeons and neurosurgeons.

Conclusions There has been a significant decline in vertebroplasty and kyphoplasty procedures in the FFS Medicare population between 2004 and 2014.

  • Spine
  • Malignant

Statistics from


  • Contributors JAH and LM constructed the study, analyzed/synthesized the data, and crafted the original manuscript. VP organized the data. RVC, ALB, and JDB edited the preliminary draft and provided meaningful editorial suggestions. All authors take responsibility for the final manuscript.

  • Competing interests JAH has an ongoing consulting relationship with Medtronic and in the past 36 months consulted for Carefusion. Both companies make products for vertebral augmentation. JB: shareholder in Medtronic and Stryker; research support from Merit/DFine and Medtronic.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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