William Brian Morrison MD, Presenter: Nothing to Disclose

Andrea J Frangos MPH, Abstract Co-Author: Nothing to Disclose

Laurence Parker PhD, Abstract Co-Author: Nothing to Disclose

Adam C. Zoga MD, Abstract Co-Author: Nothing to Disclose

Diane Marie Deely MD, Abstract Co-Author: Nothing to Disclose

John Anthony Carrino MD, Abstract Co-Author: Nothing to Disclose

The primary indication for vertebroplasty (VP) is osteoporotic compression fracture. Osteoporosis is systemic, and many patients have repeat fracture. However, reports of repeat fracture shortly after VP may be related to sudden alteration of mechanical stress across the vertebral column. We sought to examine this effect by tracking the number of VP procedures performed on individual patients over a period of one year in the Medicare population.

The data source was the 5% sample CMS Limited Data Set Part B data for the year 2002. This dataset is a sample of all procedure claims for 36.5 million fee-for-service Medicare beneficiaries. We extracted all claims for VP codes (thoracic, lumbar, and additional levels); for each procedure a primary thoracic or lumbar code is applied. The number of separate VP visits during the year was determined by the frequency of duplicate primary codes for individual patients in the sample. The rate of additional levels in individual patients was also determined. Figures were extrapolated to the overall Medicare population by multiplying 5% sample findings by 20, and 95% confidence intervals were calculated.

25,500 (+/-1,751) VP claims were reimbursed in 2002 on 16,280 (+/-1,118) patients. 39.2% represented thoracic claims, 41.8% lumbar, and 19.0% additional levels. Over the one year period, 65.6% of patients had one level treated; 34.4% had multiple levels treated (21.6% had two levels; 7.5% had three; 3.3% had four; 1.0% had five; 1.0% had more than five). 84.6% of patients treated had only one visit. 15.4% had more than one primary code reimbursed, indicating multiple separate procedures performed during the year (33.6% had multiple thoracic, 26.4% had multiple lumbar, and 40.0% had a combination of thoracic and lumbar procedures). Of the patients with multiple separate procedures, 77.6% had two, 17.6% had three, and 4.8% had four return visits during the year.

A large proportion of patients (34.4%) undergoing vertebroplasty have multiple levels treated during a one year period. A relatively large proportion (15.4%) of patients return for an additional vertebroplasty treatment within this short time period.

Morrison, W, Frangos, A, Parker, L, Zoga, A, Deely, D, Carrino, J, Vertebroplasty in the U.S.: Utilization and Prevalence of Multiple and Repeat Procedures.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4419391.html