Surgery to treat vertebral fractures due to osteoporosis

People with osteoporosis (bone loss) have unstable bones and an increased risk of fractures. Vertebral fractures, which often heal on their own, are a common complication. However, there are also therapeutic options whereby the vertebra is stabilised by means of a minor surgical intervention and then filled with bone cement, either directly or using a previously inserted balloon. This report examines the efficacy, safety, cost effectiveness and budgetary impact, taking into account legal, social, ethical and organisational aspects.

The approximately 30 studies included in the review provided inconsistent data. Compared with conservative non-surgical methods, the surgical interventions did relieve pain, but only with short-term benefits. After a year, the differences were only minimal. By contrast, surgical interventions to treat acute vertebral fractures produced better outcomes. The cost effectiveness aspect is controversial as the surgical intervention incurs additional costs and there was no measurable improvement in quality of life. On the other hand, it did involve shorter stays in healthcare institutions. Abolishing the reimbursement of both surgical therapeutic options would reduce the budget by CHF 10 million to CHF 13.5 million a year. No legal, social, ethical or organisational issues were identified.

The report concludes that surgical interventions have a positive impact compared with conservative therapy in the short term and in particular in the case of acute fractures. The cost effectiveness aspect is debatable as the interventions incur costs, although they involve shorter stays in healthcare institutions. Abolishing the reimbursement of both interventions would allow savings for health insurance funds and insured persons.