Percutaneous vertebroplasty as a treatment for osteoporotic vertebral fractures
Percutaneous Vertebroplasty (PVP) is a pain relieving procedure with prompt effect and few complications in patients with acute as well as chronic, osteoporotic vertebral fractures. Technically bone cement, usually polymethylmetacrylat (PMMA), is injected in the vertebral body under fluoroscopic control.
The purpose of this health technology assessment is to provide sufficient evidence for decision-makers before introduction of PVP in Danish hospitals.
PVP is recommended to patients with persistent pain after a period of conservative treatment. Conservative treatment for traditionally patients with osteoporotic compression fractures is bed rest, analgetics, brace treatment and physiotherapy. Patients with acute pain will recover spontaneously in most cases.
Acute and subacute osteoporotic, vertebral fractures cost DKK 64.000 (€8.600) for conservatively treated patients and DKK 50.000 (€6.700) for patients treated with PVP. The economic avantage is predominantly due to shorter hospitalization for operated patients compared to conservatively treated patients.
The effect of PVP is documented in a clinical, randomised study at the University Hospital of Odense on acute and subacute, osteoporotic vertebral fractures. The effect on chronic pain is documented in several international studies and in the clinical nonramdomised study at the University Hospital of Odense.