Balancing Science and Informed Choice in Decisions about Vertebroplasty

Worldwide there are approximately 1.4 million persons with vertebral compression fractures.1 In the United States, there are approximately 750,000; only one third receive treatment.2 Prevalence estimates are imprecise because of heterogeneity in how vertebral fracture is defined.3 Annualized direct care expenditures for osteoporotic fractures in the United States were estimated to range from $12 billion to $18 billion in 2002.2 Several treatments (e.g., bed rest, bracing, and pain medications) have been designed to foster pain relief and allow for increased activities. Percutaneous vertebroplasty — the injection of polymethylmethacrylate directly into the vertebral compression fracture — has emerged as a treatment . . .