1466 - Vertebroplasty for severely painful osteoporotic vertebral fractures of less than 6 weeks duration

Page last updated: 15 December 2016

Application Detail

Status

Open

Description of Medical Service

The procedure is performed in an Interventional Radiology suite using local anaesthesia. High quality fluoroscopic imaging is required. A needle is passed through the skin of the back and into the fractured vertebral body. The trabecular space of the vertebral body is progressively filled with polymethyl methacrylate (PMMA) using fluoroscopic imaging to guide the injection. The procedure is terminated when the vertebral body has an adequate distribution of PMMA to stabilise the fractured vertebral body (distribution from superior to inferior endplate and anterior cortex to posterior third of vertebral body in lateral projection and from pedicle to pedicle in frontal projection), or if PMMA begins to extravasate outside of the bone. The patient can be mobilised after 2 hours and outpatients can be discharged home at this time.

Description of Medical Condition

Osteoporotic vertebral fractures are increasingly prevalent as the population ages. Most osteoporotic vertebral fractures cause mild or moderate symptoms and do not require intervention. A small but significant subset of patients experience severe pain and loss of function following the fracture. This can cause loss of independence and hospitalisation. Vertebroplasty can be used to provide pain relief when the pain is severe and poorly controlled by medication, and when the fracture is less than 6 weeks in duration. The alternative, larger dose of opiate analgesics causes many side effects in this patient group including delirium, nausea, constipation and increased propensity to falls. This patient group includes both outpatients and inpatients. The assumption that pain due to osteoporotic spinal fractures is self-limiting is incorrect in this patient sub-group with poor outcomes at 6 months in the placebo group of the VAPOUR trial.

Reason for Application

New MBS item

Medical Service Type

Therapeutic medical service

Previous Application Number

27.1

Associated Documentation

Application Form

Application form (PDF 383 KB)
Application form (Word 118 KB)

Flow chart question 26 (PDF 340 KB)
Flow chart question 26 (Word 42 KB)

Flow chart question 40 (PDF 103 KB)
Flow chart question 40 (Word 46 KB)

IRSA Vertebroplasty MSAC letter (PDF 515 KB)
IRSA Vertebroplasty MSAC letter (Word 803 KB)

PICO Confirmation

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Assessment Report

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Public Summary Document

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Meetings for this Application

PASC

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ESC

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MSAC

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