Surgical Procedures

Only a small proportion of patients hospitalized with a spinal fracture undergo surgery. Of the 334,300 hospital admissions in the NIS database, fusion (8.8%) and kyphoplasty/vertebroplasty (10.6%) were the most common procedures performed. Similar rates of procedures were found in the NEDS hospitalized patients and National Hospital Discharge Survey (NHDS) databases. (Reference Table 3.5.1 PDF [1] CSV [2])

The majority of spinal fusion procedures on spine fractures were performed on patients under the age of 44 years, with patients age 65 years and older rarely undergoing surgery for spinal fractures. This is due to a much higher rate of fusion procedures performed on patients with traumatic fractures than on patients with VCFs. (Reference Table 3.5.2 PDF [3] CSV [4])


Fusions were performed most frequently in the cervical spine (41%), followed by thoracic spine (38%) and lumbar spine (26%). On average across the three databases included in the analysis, three out of four fusions performed were on four or fewer levels, with the remaining quarter of procedures involving five or more levels. (Table 3.5.3 PDF [5] CSV [6])

On the average, of 305,600 patients discharged with diagnosis of a vertebral compression fracture, 12% were treated with a kyphoplasty/vertebroplasty procedure. These patients were twice as likely to be female, and were most likely to be 65 or older. (Reference Table 3.5.4 PDF [7] CSV [8])