Cost-effectiveness Analysis of Conservative Treatment, Vertebroplasty, and Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures in South Korea

Abstract

Study Design: Retrospective study. Objectives: To compare the cost-effectiveness of conservative treatment, vertebroplasty (VP), and balloon kyphoplasty (KP) for osteoporotic vertebral compression fracture (OVCF). Summary of Literature Review: Cement augmentation can be an effective treatment for OVCF because it can relieve acute pain and enable patients to walk earlier. However, there has been no cost-effectiveness analysis of the available treatment options for OVCF in South Korea. Materials and Methods: In total, 183 patients diagnosed with acute OVCF with intractable pain who were hospitalized between January 2014 and February 2019 were studied retrospectively. Clinical outcomes, treatment costs during hospitalization, and outpatient costs were investigated for all patients. Results: Of the 183 patients, 42 received conservative treatment (group C), 110 underwent KP (group K), and 31 underwent VP (group V). No significant differences were found between the groups in initial visual analog scale (VAS) scores; however, 4-week follow-up VAS scores were significantly lower in groups K and V than in group C. One-year follow-up VAS scores were similar in the three groups. Significant differences were observed in the period from the diagnosis of OVCF to independent walking after injury, with groups K and V showing earlier independent walking than group C. Total costs were not significantly different between the groups at 4-week and 1-year follow-ups. Conclusions: Cement augmentation is a cost-effective treatment for OVCF with intractable pain in South Korea up to 4 weeks of followup, because it can relieve acute pain and allow early ambulation at the same cost as conservative treatment.