NICE releases draft guidance recommending vertebroplasty and balloon kyphoplasty for fractured vertebrae


On 2 November, the UK’s National Institute for Health and Clinical Excellence (NICE) opened a consultation on draft guidance which provisionally recommends the use of two treatments for fractured bones in the spine (vertebrae) caused by osteoporosis.

The draft guidance says that percutaneous vertebroplasty and percutaneous balloon kyphoplasty are recommended as options for treating osteoporotic vertebral compression fractures only in people:

• Who have severe ongoing pain after a recent vertebral fracture (within six weeks) despite optimal pain management and

• in whom the pain has been confirmed to be at the level of the fracture (by physical examination and imaging).

Osteoporotic vertebral compression fractures can have a major impact on quality of life, and can be painful and disabling. There can also be significant adverse effects caused by the high doses of analgesics used to treat the pain, which can add to the distress and loss of self-esteem caused by the symptoms. We are therefore pleased to provisionally recommend vertebroplasty and kyphoplasty, two treatments that can help to strengthen fractured bone and reduce pain,” said Carole Longson, director of the Health Technology Evaluation Centre at NICE.

“NICE has previously published interventional procedures guidance which set out that vertebroplasty and kyphoplasty were safe enough to be considered for use in the NHS. This draft technology appraisal guidance highlights that as these procedures are very cost effective, providing benefits to patients and value for money, they ought to be offered to the people specified. We welcome comments on these draft recommendations as part of the consultation,” said Longson.

The draft guidance titled: “Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures” is available here. NICE has not yet issued final guidance to the NHS.