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Vertebroplasty and kyphoplasty are similar medical spinal procedures in which bone cement is injected through a small hole in the skin (percutaneously) into a fractured vertebra with the goal of relieving back pain caused by vertebral compression fractures. It was found not to be effective in treating osteoporosis-related compression fractures of the spine in the only two placebo controlled and randomized clinical trials that have been conducted.〔 The people in both the experimental and placebo groups of the blinded study reported improvement in their pain, suggesting that the benefit noted in unblinded trials is related to the placebo effect. The cost of vertebroplasty in Europe as of 2010 was ~2,500 Euro.〔 As of 2010 in the United States, when done as an outpatient, vertebroplasty costs around 3300 USD while kyphoplasty costs around 8100 USD and when done as an inpatient vertebroplasty cost ~11,000 USD and kyphoplasty 16,000 USD. == Effectiveness == The effectiveness of vertebroplasty is disputed.〔 The only two randomized placebo controlled trials done as of 2014 found no benefit in those with osteoporosis-related fractures. The subjects in these trials had primarily non-acute fractures and prior to the release of the results they were considered the most ideal people to receive the procedure. After trial results were released vertebroplasty advocates pointed out that people with acute vertebral fractures were not investigated.〔 A number of non-blinded trials suggested effectiveness, but the lack of blinding limits what can be concluded from the results and some have been criticized because of being funded by the manufacturer.〔 One analysis has attributed the difference to selection bias. Some have suggested that this procedure only be done in those with fractures less than 8 weeks old; however, analysis of the two blinded trials appear not to support the procedure even in this acute subgroup. Others consider the procedure only appropriate for those with other health problems making rest possibly detrimental, those with metastatic cancer as the cause of the spine fracture, or those who do not improve with conservative management. Evidence does not support a benefit of kyphoplasty over vertebroplasty with respect to pain, but the procedures may differ in restoring lost vertebral height, and in safety issues like cement extravasation (leakage).〔 As with vertebroplasty, several unblinded studies have suggested a benefit from balloon kyphoplasty. , no blinded studies have been performed, and since the procedure is a derivative of vertebroplasty, the unsuccessful results of these blinded studies have cast doubt upon the benefit of kyphoplasty generally. Some vertebroplasty practitioners and some health care professional organizations continue to advocate for the procedure.〔Moan R. (continues over value of vertebroplasty ). Diagnostic Imaging. 2010;32(2) 5.〕 In 2010, the Board of Directors of the American Academy of Orthopaedic Surgeons released a statement recommending strongly against use of vertebroplasty for osteoporotic spinal compression fractures, while the Australian Medical Services Advisory Committee considers both vertebroplasty and kyphoplasty only to be appropriate in those who have failed to improve after a trial of conservative treatment,〔 with conservative treatment (analgesics primarily) being effective in two-thirds of people. The National Institute for Health and Care Excellence similarly states that the procedure in those with osteoporotic fractures is only recommended as an option if there is severe ongoing pain from a recent fracture even with optimal pain management. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Percutaneous vertebroplasty」の詳細全文を読む スポンサード リンク
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