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Kyphoplasty & Vertebroplasty Paradigm Shift in USA Market – Opportunities for Spine Radiologists (Neuroradiologists, Intreventional Neuroradiologists, Interventional Radiologists) 2011

Interventional Spine

H., Paul, Hatten, Jr., M.D.

Paper/Non-Mentor

Purpose

In medicine, treatment algorithms and procedural methods continuously evolve in response to technology, reimbursement, clinical knowledge, site of service and patient preference. These dynamics provide opportunity for physicians most willing and technically prepared to recognize and serve as leaders in this evolution. Acute vertebral compression fractures (VCFs) are often treated with vertebral augmentation. Consideration of procedural forecasts and related opportunities, spine radiologists are positioned to serve as procedure advocates and first line "primary care" providers for osteoporosis patients & patients with tumors involving vertebral bodies.

Methods & Materials

Market research data are available for current and future trends in interventional procedures. Categorical evaluation of procedure type, procedural volume, site of service, physician discipline are provided and used to evaluate market potential and trends. Analysis of these data is used to forecast volumes of both kyphoplasty & vertebroplasty procedures by spine surgeons and spine radiologists for both procedures.

Results

Market research estimates 193,000 osteoporotic and oncology VCF minimally invasive procedures will be performed in 2010 in USA with an expected 4 year compounded annual growth rate (CAGR) of 7%.(1) Spine radiologists (neuroradiologists, interventional neuroradiologists, interventional radiologists) have performed the majority of vertebroplasties (58.2% in 2008).(2) Spine surgeons have dominated the kyphoplasty market (72.8% in 2008)(2) due primarily to targeted marketing of balloon kyphoplasty. iData Research, Inc. forecasts spine radiologists will acquire 53% of the growth estimated to occur in vertebroplasty & kyphoplasty by 2014 (Figure 1).

Conclusion

Given 700,000 VCFs occur annually in the US and a shift in VCF procedures away from spine surgeons, spine radiologists are uniquely positioned to dominate an existing U.S. market for osteoporotic and oncology VCFS of $460 million, which represents over $2 billion dollars in site of service and physician provider fees, based on current reimbursement. Educating the referral community, patients, payors and administrators to recent (Klazen et al and Wardlaw et al) and extensive historical evidence demonstrating clinical significance of these procedures is an opportunity to enlighten both referring physicians as well as spine surgeons no longer interested in performing these procedures. The surgical community has shown an unwillingness to defend vertebroplasty and kyphoplasty procedures. Spine radiologists must fill this void, to avoid payors heightened scrutiny of these procedures putting future reimbursement at risk. The spine radiology community is well positioned to treat these patients (in some cases as â