Percutaneous vertebroplasty (IPG12)

  • Interventional procedures IPG12
  • Issued: September 2003
    • Percutaneous vertebroplasty

      The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Percutaneous vertebroplasty in September 2003.

      Further recommendations have been made as part of the clinical guideline on metastatic spinal cord compression published in November 2008, as follows:

      Vertebroplasty or kyphoplasty should be considered for patients who have vertebral metastases and no evidence of MSCC or spinal instability if they have either:

      • mechanical pain resistant to analgesia, or
      • vertebral body collapse.

      Vertebroplasty or kyphoplasty for spinal metastases should only be performed after agreement between appropriate specialists including an oncologist, interventional radiologist, and spinal surgeon, and in facilities where there is good access to spinal surgery.

      Clinical and cost-effectiveness evidence was reviewed in the development of this guideline which has led to this more specific recommendation. More information is available from www.nice.org.uk/CG75. The IP guidance on percutaneous vertebroplasty remains current, and should be read in conjunction with the clinical guideline.

      The Medicines and Healthcare Products Regulatory Agency (MHRA) has issued safety notices relating to this procedure (Reference No. MDA/2003/021).

      • Description

        Percutaneous vertebroplasty is a treatment for vertebral compression fractures, which are a common cause of pain and disability. Each year over 270,000 painful vertebral fractures are clinically diagnosed in the USA, and numbers are increasing. Osteopenia associated with aging or chronic steroid use and metastatic disease are the most common aetiologies of vertebral compression fractures. All patients experience pain, which can be of varied duration. Most patients are treated conservatively with analgesics, bedrest and bracing, but a small percentage is left with persistent pain and limited mobility.

        Percutaneous vertebroplasty may be used to provide pain relief for patients with severe painful osteoporosis with loss of height and/or with compression fractures of the vertebral body and also for patients with symptomatic vertebral haemangioma and painful vertebral body tumours (metastasis and myeloma).

        Percutaneous vertebroplasty involves the injection of acrylic bone cement into the vertebral body in order to relieve pain and/or stabilise the fractured vertebrae and in some cases, restore vertebral height.

      • OPCS4.6 Code(s)

        V44.4 Vertebroplasty of fracture of spine

        V55.- Levels of spine

        Y53.- Approach to organ under image control

        Site code

        Note: Codes within category V55.-  are assigned in second place each time a spinal operation is coded. If the levels of spine are not specified V55.9 Unspecified levels of spine is used.

         Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control, if the method of image control is unspecified Y53.9 Unspecified approach to organ under image control is assigned.

        The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding

      • Other information

      This page was last updated: 15 June 2012

    • Guidance formats


      Information for the public Percutaneous vertebroplasty

      Information for the public

Implementation tools and resources

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The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.

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The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.

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The published full clinical guidance for specialists with background, evidence, recommendations and methods used.

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.