Article preview from Medtech Insight - October 1, 2011
Although the spine market appears to be stabilizing to some extent, the vertebral compression fracture market continues to be challenged by reimbursement issues and lingering controversy stemming from the New England Journal of Medicine articles questioning the efficacy of vertebroplasty and vertebral augmentation as a treatment for VCFs.
Article preview from Medtech Insight - October 1, 2011
Although the spine market appears to be stabilizing to some extent, the vertebral compression fracture (VCF) market continues to be challenged by reimbursement issues and lingering controversy. The latter stems from August 2009's New England Journal of Medicine articles questioning the efficacy of vertebroplasty and vertebral augmentation (ie, kyphoplasty) as a treatment for vertebral compression fractures.
BioMedGPS projects that the 2011 US market for VCF repair will reach approximately $385 million, but will experience declining growth of about -4.2% per annum going forward, bottoming out at $350 million in 2015. While the number of patients presenting with VCFs is projected to grow as the 65+ age group increases in size, the percentage of patients treated is expected to decline. Another reason for the negative market growth is a shift away from more expensive vertebral augmentation procedures, performed with specialized instrumentation, toward a more traditional vertebroplasty approach using simple cannulas. Some 45% of the 148,000 patients with VCFs were treated with vertebroplasty in 2011, with 55% undergoing vertebral augmentation. Revenues for vertebroplasty products are expected to reach $90 million this year, whereas vertebral augmentation will top $294 million.
The effectiveness of vertebral augmentation, or kyphoplasty, over vertebroplasty has yet to be demonstrated convincingly. A metaanalysis published in the June issue of International Orthopaedics showed that vertebroplasty is more effective in short-term pain relief compared to kyphoplasty; however, kyphoplasty demonstrated superior functional improvement at three months. The study found no significant difference in long-term pain relief and functional improvement or risk of subsequent fracture and cement leakage – and cement leakage was one the major reasons for physicians' use of kyphoplasty.
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