Purpose of Review

To review the utilization patterns of vertebral augmentation procedures in the US Medicare population from 2004 to 2017 surrounding concurrent developments in the literature and the enactment of the Affordable Care Act (ACA).

Recent Findings

The analysis of vertebroplasty and kyphoplasty utilization patterns was carried out using specialty utilization data from the Centers for Medicare and Medicaid Services Database. Of note, over the period of time between 2009 and 2017, the number of people aged 65 or older showed a 3.2% rate of annual increase, and the number of Medicare beneficiaries increased by 27.6% with a 3.1% rate of annual increase. Concurrently, vertebroplasty utilization decreased 72.8% (annual decline of 15% per 100,000 Medicare beneficiaries), and balloon kyphoplasty utilization decreased 19% (annual decline of 2.6% per 100,000 Medicare beneficiaries). This translates to a 38.3% decrease in vertebroplasty and balloon kyphoplasty utilization (annual decline of 5.9% per 100,000 Medicare beneficiaries) from 2009 to 2017. By contrast, from 2004 to 2009, there was a total 188% increase in vertebroplasty and balloon kyphoplasty utilization (annual increase rate of 23.6% per 100,000 Medicare beneficiaries). The majority of vertebroplasty procedures were done by radiologists, and the majority of kyphoplasties were done by aggregate groups of spine surgeons.

Summary

These results illustrate a significant decline in vertebral augmentation procedures in the fee-for-service Medicare population between 2004 and 2017, with dramatic decreases following the publication of two 2009 trials that failed to demonstrate benefit of vertebroplasty over sham and the enactment of the ACA.

中文翻译：

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在美国使用椎骨增强手术：在2009年医疗保险付费服务人群中进行的比较分析。

审查目的

回顾2004年至2017年美国Medicare人群中椎体增强手术的利用模式，以及相关文献的同时发展以及《 Affordable Care Act（ACA）》的制定。

最近的发现

使用来自Medicare和Medicaid Services数据库中心的专业利用数据对椎骨成形术和后凸成形术利用模式进行了分析。值得注意的是，在2009年至2017年期间，65岁或65岁以上人口的年增长率为3.2％，医疗保险受益人的数量以27％的速度增长，年增长率为3.1％。同时，椎体成形术的利用率下降了72.8％（每100,000个Medicare受益人每年下降15％），球囊后凸成形术的利用率下降了19％（每100,000 Medicare受益人每年下降2.6％）。从2009年到2017年，椎骨成形术和球囊后凸成形术的使用率下降了38.3％（每10万医疗保险受益人每年下降5.9％）。相比之下，从2004年到2009年，椎骨成形术和球囊后凸成形术的使用总共增加了188％（每100,000个Medicare受益人每年增加23.6％）。大部分椎体成形术是由放射科医生完成的，而大多数后凸成形术是由脊柱外科医生的聚集组完成的。

概要

这些结果表明，2004年至2017年间，按服务付费的Medicare人群中椎骨增强手术的数量显着下降，在2009年发表的两项未能证明椎体成形术优于假手术的益处以及ACA颁布之后，两项研究显着下降。