Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, Philadelphia, PA 19107, USA.
AJR Am J Roentgenol. 2012 Dec;199(6):1358-64. doi: 10.2214/AJR.12.8733.
The purpose of this study was to determine the utilization by specialty and guidance method for vertebral augmentation (including vertebroplasty and kyphoplasty) in the United States from 2001 to 2010.
Using the 2001 through 2010 United States part B Medicare claims database, we studied the CPT-4 (Current Procedural Terminology, 4th ed.) codes used for thoracic (22520) and lumbar (22521) vertebroplasty, thoracic (22523) and lumbar (22524) kyphoplasty, and the method of radiologic guidance (76012 for fluoroscopy and 76013 for CT). For each of these codes, volume and physician specialty were tabulated.
Radiologists performed 73% of Medicare-reimbursed vertebroplasty procedures in the United States in 2001-2010 and 30% of kyphoplasty procedures from 2006 to 2010. The majority were performed by nonradiologists, most notably orthopedic surgeons, who accounted for 40%. Although there was a decrease in utilization of vertebroplasty and kyphoplasty from 2009 to 2010, the number of vertebroplasties increased by 72.9% from 2001 to 2010, and the number of kyphoplasties increased by 12.0% from 2006 to 2010. Fluoroscopy is nearly universal as a guidance method for both vertebroplasty and kyphoplasty.
This study shows that despite controversy regarding the long-term efficacy of vertebral augmentation, including vertebroplasty and kyphoplasty, utilization has risen since these procedures have been instituted and fluoroscopy is nearly universal as a guidance method. For vertebroplasty, the decrease in utilization from 2007 to 2009 may be explained in part by a combination of the initiation of kyphoplasty codes in 2006 and the August 2009 Kallmes et al. and Buchbinder et al. publications. Decreased utilization of both vertebroplasty and kyphoplasty from 2009 to 2010 may also be partly due to these publications.
本研究旨在确定 2001 年至 2010 年美国脊椎骨强化术（包括椎体成形术和后凸成形术）的专业和指导方法的利用情况。
利用 2001 年至 2010 年美国医疗保险 B 部分索赔数据库，我们研究了 CPT-4（当前程序术语，第 4 版）代码，用于胸（22520）和腰（22521）椎体成形术、胸（22523）和腰（22524）后凸成形术以及放射学指导方法（透视 76012 和 CT 76013）。对于这些代码中的每一个，都记录了数量和医生的专业。
2001-2010 年，放射科医生在美国实施了医疗保险报销的脊椎骨强化术的 73%，2006-2010 年实施了后凸成形术的 30%。大多数是由非放射科医生完成的，特别是骨科医生，占 40%。尽管从 2009 年到 2010 年，椎体成形术和后凸成形术的使用率有所下降，但从 2001 年到 2010 年，椎体成形术的数量增加了 72.9%，从 2006 年到 2010 年，后凸成形术的数量增加了 12.0%。透视术几乎是椎体成形术和后凸成形术的通用指导方法。
本研究表明，尽管对脊椎骨强化术（包括椎体成形术和后凸成形术）的长期疗效存在争议，但自这些手术开始以来，其使用率有所上升，透视术几乎是一种通用的指导方法。对于椎体成形术来说，2007 年至 2009 年使用率的下降部分可以解释为 2006 年后凸成形术代码的启动以及 2009 年 8 月 Kallmes 等人和 Buchbinder 等人的出版物。2009 年至 2010 年椎体成形术和后凸成形术使用率的下降也可能部分归因于这些出版物。
