Editing Vertebral augmentation (section)

==Society and culture==

===Cost===
The cost of vertebroplasty in Europe as of 2010 was ~2,500 Euro.<ref name=Mon2012/> As of 2010 in the United States, when done as an outpatient, vertebroplasty costs around US$3300 while kyphoplasty costs around US$8100 and when done as an inpatient vertebroplasty cost ~US$11,000 and kyphoplasty US$16,000.<ref name=Mehio2011>{{cite journal|last=Mehio|first=AK|author2=Lerner, JH |author3=Engelhart, LM |author4=Kozma, CM |author5=Slaton, TL |author6=Edwards, NC |author7= Lawler, GJ |title=Comparative hospital economics and patient presentation: vertebroplasty and kyphoplasty for the treatment of vertebral compression fracture.|journal=AJNR. American Journal of Neuroradiology|date=August 2011|volume=32|issue=7|pages=1290–4|pmid=21546460|doi=10.3174/ajnr.A2502|pmc=7966060|doi-access=free}}</ref> The cost difference is due to kyphoplasty being an in-patient procedure while vertebroplasty is outpatient, and due to the [[Balloon catheter|balloons]] used in the kyphoplasty procedure.<ref>{{cite journal|last1=Cloft|first1=HJ|last2=Jensen|first2=ME|title=Kyphoplasty: an assessment of a new technology.|journal=AJNR. American Journal of Neuroradiology|date=February 2007|volume=28|issue=2|pages=200–3|pmid=17296979|pmc=7977394 }}</ref> Medicare in 2011 spent about US$1 billion on the procedures.<ref name=NYT2011/> A 2013 study found that "the average adjusted costs for vertebroplasty patients within the first quarter and the first 2 years postsurgery were $14,585 and $44,496, respectively. The corresponding average adjusted costs for kyphoplasty patients were $15,117 and $41,339. There were no significant differences in adjusted costs in the first 9 months postsurgery, but kyphoplasty patients were associated with significantly lower adjusted treatment costs by 6.8–7.9% in the remaining periods through two years postsurgery."<ref>{{cite journal|last1=Ong|first1=KL|last2=Lau|first2=E|last3=Kemner|first3=JE|last4=Kurtz|first4=SM|title=Two-year cost comparison of vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: are initial surgical costs misleading?|journal=Osteoporosis International|date=April 2013|volume=24|issue=4|pages=1437–45|pmid=22872070|doi=10.1007/s00198-012-2100-0|s2cid=22020223}}</ref>

=== Medicare response ===
In response to the NEJM articles and a medical record review showing misuse of vertebroplasty and kyphoplasty, [[Medicare (United States)|US Medicare]] [[Medicare (United States)#Administrator|contractor]] Noridian Administrative Services (NAS) conducted a literature review and formed a policy regarding reimbursement of the procedures. NAS states that in order to be reimbursable, a procedure must meet certain criteria, including, 1) a detailed and extensively documented medical record showing pain caused by a fracture, 2) radiographic confirmation of a fracture, 3) that other treatment plans were attempted for a reasonable amount of time, 4) that the procedure is not performed in the emergency department, and 5) that at least one year of follow-up is planned for, among others. The policy, as referenced, applies only to the region covered by Noridian and not all of Medicare's coverage area. The reimbursement policy became effective on 20 June 2011.<ref name="Noridian">{{cite web|url=http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=24383&ContrNum=03102 |title=Local Coverage Determination (LCD) for Vertebroplasty, Vertebral Augmentation; Percutaneous (L24383) |author=Noridian Administrative Services, LLC |work=[[Centers for Medicare and Medicaid Services]] |publisher=[[United States Department of Health and Human Services]] |access-date=18 October 2011}}</ref> A 2015 comparative study of Medicare patients with vertebral compression fractures found that those who received balloon kyphoplasty and vertebroplasty therapies experienced lower mortality and overall morbidity than those who received conservative nonoperative management.<ref>{{Citation | last1 =Edidin | first1 =Avram | last2 =Ong | first2 =Kevin| title = Morbidity and Mortality After Vertebral Fractures: Comparison of Vertebral Augmentation and Nonoperative Management in the Medicare Population | journal = [[Spine (journal)|Spine]] | volume =40 | issue =15 | pages = 1228–41 | date =2015 | language =en |pmid= 26020845 | doi= 10.1097/BRS.0000000000000992| s2cid =20164158 }}</ref>

=== Promotion ===
In 2015, it was reported by ''The Atlantic'' that a person associated with a medical device company that sells equipment related to the kyphoplasty procedure had edited the Wikipedia article on the subject to promote claims about its efficacy.<ref>{{Cite news|last=Pinsker|first=Story by Joe|title=The Covert World of People Trying to Edit Wikipedia—for Pay|work=The Atlantic|url=https://www.theatlantic.com/business/archive/2015/08/wikipedia-editors-for-pay/393926/|access-date=2020-05-26|issn=1072-7825}}</ref> Assertions about the positive effects of kyphoplasty have been found to be unsupported or disproven, according to independent researchers.<ref>{{Cite news|last=Kolata|first=Gina|date=2019-01-24|title=Spinal Fractures Can Be Terribly Painful. A Common Treatment Isn't Helping.|language=en-US|work=The New York Times|url=https://www.nytimes.com/2019/01/24/health/spinal-fracture-treatment.html|access-date=2020-05-26|issn=0362-4331}}</ref>