377:
caused by a fracture, 2) radiographic confirmation of a fracture, 3) that other treatment plans were attempted for a reasonable amount of time, 4) that the procedure is not performed in the emergency department, and 5) that at least one year of follow-up is planned for, among others. The policy, as referenced, applies only to the region covered by
Noridian and not all of Medicare's coverage area. The reimbursement policy became effective on 20 June 2011. A 2015 comparative study of Medicare patients with vertebral compression fractures found that those who received balloon kyphoplasty and vertebroplasty therapies experienced lower mortality and overall morbidity than those who received conservative nonoperative management.
235:(of certain types), followed by its stabilization using injected bone cement. The procedure typically includes the use of a small balloon that is inflated in the vertebral body to create a void within the cancellous bone prior to cement delivery. Once the void is created, the procedure continues in a similar manner as a vertebroplasty, but the bone cement is typically delivered directly into the newly created void.
299:
42:
220:
272:(leakage). As with vertebroplasty, several unblinded studies have suggested a benefit from balloon kyphoplasty. As of 2012, no blinded studies have been performed, and since the procedure is a derivative of vertebroplasty, the unsuccessful results of these blinded studies have cast doubt upon the benefit of kyphoplasty generally.
361:
average adjusted costs for kyphoplasty patients were $ 15,117 and $ 41,339. There were no significant differences in adjusted costs in the first 9 months postsurgery, but kyphoplasty patients were associated with significantly lower adjusted treatment costs by 6.8–7.9% in the remaining periods through two years postsurgery."
342:. A report of this and 6 other patients was published in 1987 and it was introduced in the United States in the early 1990s. Initially, the treatment was used primarily for tumors in Europe and vertebral compression fractures in the United States, although the distinction has largely gone away since then.
200:. It is a minimally invasive procedure and patients usually go home the same or next day as the procedure. Patients are given local anesthesia and light sedation for the procedure, though it can be performed using only local anesthetic for patients with medical problems who cannot tolerate sedatives well.
1120:
Jensen, ME; McGraw, JK; Cardella, JF; Hirsch, JA (July 2009). "Position statement on percutaneous vertebral augmentation: a consensus statement developed by the
American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, American Association of Neurological
355:
The cost of vertebroplasty in Europe as of 2010 was ~2,500 Euro. As of 2010 in the United States, when done as an outpatient, vertebroplasty costs around US$ 3300 while kyphoplasty costs around US$ 8100 and when done as an inpatient vertebroplasty cost ~US$ 11,000 and kyphoplasty US$ 16,000. The cost
310:
The risk of new fractures following these procedures does not appear to be changed; however, evidence is limited, and an increase risk as of 2012 is not ruled out. Pulmonary cement embolism is reported to occur in approximately 2-26% of procedures. It may occur with or without symptoms. Typically, if
260:
Some have suggested that this procedure only be done in those with fractures less than 8 weeks old; however, analysis of the two blinded trials appear not to support the procedure even in this acute subgroup. Others consider the procedure only appropriate for those with other health problems making
279:
released a statement recommending strongly against use of vertebroplasty for osteoporotic spinal compression fractures, while the
Australian Medical Services Advisory Committee considers both vertebroplasty and kyphoplasty only to be appropriate in those who have failed to improve after a trial of
247:
As of 2019, the effectiveness of vertebroplasty is not supported. A 2018 Cochrane review found no role for vertebroplasty for the treatment of acute or sub-acute osteoporotic vertebral fractures. The subjects in these trials had primarily non-acute fractures and prior to the release of the results
376:
Noridian
Administrative Services (NAS) conducted a literature review and formed a policy regarding reimbursement of the procedures. NAS states that in order to be reimbursable, a procedure must meet certain criteria, including, 1) a detailed and extensively documented medical record showing pain
306:
Some of the associated risks are from the leak of acrylic cement to outside of the vertebral body. Although severe complications are extremely rare, infection, bleeding, numbness, tingling, headache, and paralysis may ensue because of misplacement of the needle or cement. This particular risk is
360:
used in the kyphoplasty procedure. Medicare in 2011 spent about US$ 1 billion on the procedures. A 2013 study found that "the average adjusted costs for vertebroplasty patients within the first quarter and the first 2 years postsurgery were $ 14,585 and $ 44,496, respectively. The corresponding
238:
In a 2011 review
Medicare contractor NAS determined that there is no difference between vertebroplasty and kyphoplasty, stating, "No clear evidence demonstrates that one procedure is different from another in terms of short- or long-term efficacy, complications, mortality or any other parameter
389:
that a person associated with a medical device company that sells equipment related to the kyphoplasty procedure had edited the
Knowledge (XXG) article on the subject to promote claims about its efficacy. Assertions about the positive effects of kyphoplasty have been found to be unsupported or
211:(PMMA), although more modern cements are used as well) quickly hardens and forms a support structure within the vertebra that provide stabilization and strength. The needle makes a small puncture in the patient's skin that is easily covered with a small bandage after the procedure.
568:; Akesson, Kristina; Bauer, Douglas C; Buchbinder, Rachelle; Eastell, Richard; Fink, Howard A; Giangregorio, Lora; Guanabens, Nuria; Kado, Deborah; Kallmes, David; Katzman, Wendy; Rodriguez, Alexander; Wermers, Robert; Wilson, H Alexander; Bouxsein, Mary L (January 2019).
252:
were not investigated. A number of non-blinded trials suggested effectiveness, but the lack of blinding limits what can be concluded from the results and some have been criticized because of being funded by the manufacturer. One analysis has attributed the difference to
1107:
1307:
939:
Itshayek, E; Miller, P; Barzilay, Y; Hasharoni, A; Kaplan, L; Fraifeld, S; Cohen, JE (June 2012). "Vertebral augmentation in the treatment of vertebral compression fractures: review and new insights from recent studies".
1315:
1337:
Bliemel, C; Oberkircher, L; Buecking, B; Timmesfeld, N; Ruchholtz, S; Krueger, A (April 2012). "Higher incidence of new vertebral fractures following percutaneous vertebroplasty and kyphoplasty--fact or fiction?".
671:
Robinson, Y; Olerud, C (May 2012). "Vertebroplasty and kyphoplasty--a systematic review of cement augmentation techniques for osteoporotic vertebral compression fractures compared to standard medical therapy".
307:
decreased by the use of X-ray or other radiological imaging to ensure proper placement of the cement. In those who have fractures due to cancer, the risk of serious adverse events appears to be greater at 2%.
1612:
Ong, KL; Lau, E; Kemner, JE; Kurtz, SM (April 2013). "Two-year cost comparison of vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: are initial surgical costs misleading?".
1797:
1232:
284:
similarly states that the procedure in those with osteoporotic fractures is only recommended as an option if there is severe ongoing pain from a recent fracture even with optimal pain management.
1080:
Zou, J; Mei, X; Zhu, X; Shi, Q; Yang, H (Jul–Aug 2012). "The long-term incidence of subsequent vertebral body fracture after vertebral augmentation therapy: a systemic review and meta-analysis".
750:
Wardlaw, Douglas; Cummings, Steven (2009), "Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial",
268:
Evidence does not support a benefit of kyphoplasty over vertebroplasty with respect to pain, but the procedures may differ in restoring lost vertebral height, and in safety issues like cement
327:
Vertebroplasty had been performed as an open procedure for many decades to secure pedicle screws and fill tumorous voids. However, the results were not always worth the risk involved with an
845:"Vertebroplasty for painful acute osteoporotic vertebral fractures: recent Medical Journal of Australia editorial is not relevant to the patient group that we treat with vertebroplasty"
1656:
Edidin, Avram; Ong, Kevin (2015), "Morbidity and
Mortality After Vertebral Fractures: Comparison of Vertebral Augmentation and Nonoperative Management in the Medicare Population",
492:
1790:
319:
In the United States in 2003 approximately 25,000 vertebroplasty procedures were paid for by
Medicare. As of 2011/2012 this number may be as high as 70,000-100,000 per year.
311:
there are no symptoms, there are no long term issues. Symptoms do occur in about 1 in 2000 procedures. Other adverse effects include spinal cord injury in 0.6 per 1000.
281:
338:
The first percutaneous vertebroplasty was performed in 1984 at the
University Hospital of Amiens, France to fill a vertebral void left after the removal of a benign
248:
they were considered the most ideal people to receive the procedure. After trial results were released vertebroplasty advocates pointed out that people with acute
1783:
275:
Some vertebroplasty practitioners and some health care professional organizations continue to advocate for the procedure. In 2010, the board of directors of the
1419:
Morrison, WB; Parker, L; Frangos, AJ; Carrino, JA (April 2007). "Vertebroplasty in the United States: guidance method and provider distribution, 2001-2003".
609:
Buchbinder, Rachelle; Johnston, Renea V.; Rischin, Kobi J.; Homik, Joanne; Jones, C. Allyson; Golmohammadi, Kamran; Kallmes, David F. (6 November 2018).
487:
125:
into the efficacy and safety of vertebral augmentation, there is still a lack of consensus regarding certain aspects of vertebroplasty and kyphoplasty.
2190:
1032:
Buchbinder R, Osborne RH, Ebeling PR, et al. (August 2009). "A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures".
2142:
276:
2302:
302:
A CT image of cement used in kyphoplasty that has entered the spinal channel and is pressing on the spinal cord resulting in neurological symptoms
57:
2307:
1522:"Comparative hospital economics and patient presentation: vertebroplasty and kyphoplasty for the treatment of vertebral compression fracture"
1504:
2048:
482:
328:
203:
During the procedure, bone cement is injected with a biopsy needle into the collapsed or fractured vertebra. The needle is placed with
2199:
2043:
2312:
1245:
434:
Wardlaw, Douglas; Van
Meirhaeghe, Jan (2012), "Balloon kyphoplasty in patients with osteoporotic vertebral compression fractures",
1492:
2102:
2097:
1158:"Cochrane vertebroplasty review misrepresented evidence for vertebroplasty with early intervention in severely affected patients"
436:
1994:
1308:"Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures"
892:"Effectiveness of vertebroplasty using individual patient data from two randomised placebo controlled trials: meta-analysis"
1701:
421:
Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D. "Vertebroplasty and Kyphoplasty" 2008. Accessed 7 Aug 2009.
280:
conservative treatment, with conservative treatment (analgesics primarily) being effective in two-thirds of people. The
707:
Gangi, A; Clark, WA (August 2010). "Have recent vertebroplasty trials changed the indications for vertebroplasty?".
2031:
197:
2135:
356:
difference is due to kyphoplasty being an in-patient procedure while vertebroplasty is outpatient, and due to the
2157:
1948:
513:
Buchbinder, R; Johnston, RV; Rischin, KJ; Homik, J; Jones, CA; Golmohammadi, K; Kallmes, DF (6 November 2018).
373:
370:
369:
In response to the NEJM articles and a medical record review showing misuse of vertebroplasty and kyphoplasty,
208:
890:
Staples, MP; Kallmes, DF; Comstock, BA; Jarvik, JG; Osborne, RH; Heagerty, PJ; Buchbinder, R (Jul 12, 2011).
844:
184:
159:
287:
1769:
1734:
1372:"Pulmonary cement embolism associated with percutaneous vertebroplasty or kyphoplasty: a systematic review"
2067:
1938:
2036:
290:, also known by the brand Kiva, is a similar procedure which also has poor evidence to support its use.
2214:
483:"Local Coverage Determination (LCD) for Vertebroplasty, Vertebral Augmentation; Percutaneous (L24383)"
2125:
1845:
1210:
The Treatment of Symptomatic Osteoporotic Spinal Compression Fractures: Guideline and Evidence Report
118:
1520:
Mehio, AK; Lerner, JH; Engelhart, LM; Kozma, CM; Slaton, TL; Edwards, NC; Lawler, GJ (August 2011).
2277:
2087:
2009:
2219:
2152:
1953:
1901:
1817:
1683:
1638:
965:
872:
777:
732:
461:
249:
227:
Kyphoplasty is a variation of a vertebroplasty which attempts to restore the height and angle of
145:
2255:
2209:
2004:
1999:
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957:
921:
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689:
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453:
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as the cause of the spine fracture, or those who do not improve with conservative management.
52:
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638:
622:
581:
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526:
445:
357:
122:
1268:"A review of vertebroplasty for osteoporotic and malignant vertebral compression fractures"
1208:
17:
2180:
2175:
1958:
1658:
1156:
Clark, William; Bird, Paul; Diamond, Terrance; Gonski, Peter; Gebski, Val (9 March 2019).
1775:
843:
Clark, WA; Diamond, TH; McNeil, HP; Gonski, PN; Schlaphoff, GP; Rouse, JC (2010-03-15).
174:
2270:
2185:
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1943:
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1009:
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Surgeons/Congress of Neurological Surgeons, and American Society of Spine Radiology".
765:
165:
133:
2296:
2080:
1979:
1922:
1840:
1485:
1387:
1054:
570:"The Efficacy and Safety of Vertebral Augmentation: A Second ASBMR Task Force Report"
565:
269:
155:
141:
1687:
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685:
2240:
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1234:
Review of interim funded service: Vertebroplasty and New review of Kyphoplasty
794:
McCullough, BJ; Comstock, BA; Deyo, RA; Kreuter, W; Jarvik, JG (Sep 9, 2013).
752:
720:
1746:
1713:
634:
611:"Percutaneous vertebroplasty for osteoporotic vertebral compression fracture"
515:"Percutaneous vertebroplasty for osteoporotic vertebral compression fracture"
2023:
1984:
1974:
1735:"Spinal Fractures Can Be Terribly Painful. A Common Treatment Isn't Helping"
1284:
1267:
114:
1770:
Spinal Fractures Can Be Terribly Painful. A Common Treatment Isn't Helping.
1679:
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1440:
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595:
548:
457:
298:
1045:
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796:"Major Medical Outcomes With Spinal Augmentation vs Conservative Therapy"
232:
228:
110:
985:"A randomized trial of vertebroplasty for osteoporotic spinal fractures"
219:
1538:
1266:
Montagu, A; Speirs, A; Baldock, J; Corbett, J; Gosney, M (July 2012).
907:
586:
569:
449:
80:
1483:
Mathis, John M.; Deramond, Hervé; Belkoff, Stephen M., eds. (2006) .
262:
1702:"The Covert World of People Trying to Edit Knowledge (XXG)—for Pay"
2058:
297:
218:
170:
140:
are the two most common procedures for spinal augmentation. These
983:
Kallmes DF, Comstock BA, Heagerty PJ, et al. (August 2009).
1825:
1807:
1779:
1370:
Wang, LJ; Yang, HL; Shi, YX; Jiang, WM; Chen, L (August 2012).
109:
is injected through a small hole in the skin into a fractured
196:
Vertebroplasty is typically performed by a spine surgeon or
1312:
NICE The National Institute for Health and Care Excellence
493:
United States Department of Health and Human Services
2228:
2168:
2113:
2066:
2057:
2022:
1967:
1931:
1915:
1859:
1833:
1824:
1240:. Medical Services Advisory Committee. April 2011.
63:
51:
34:
46:Typical interventional suite setup for kyphoplasty
1207:Esses, Stephen I.; et al. (September 2010),
390:disproven, according to independent researchers.
282:National Institute for Health and Care Excellence
261:rest possibly detrimental, those with metastatic
1573:"Kyphoplasty: an assessment of a new technology"
1123:Journal of Vascular and Interventional Radiology
423:http://www.arizonapain.com/Vertebroplasty-W.html
666:
664:
662:
182:"humped; stooping forward" (from Ancient Greek
1075:
1073:
331:, which was the reason for the development of
154:meaning "molding or shaping surgically" (from
1791:
8:
1487:Percutaneous Vertebroplasty and Kyphoplasty
1365:
1363:
1361:
1227:
1225:
1223:
709:CardioVascular and Interventional Radiology
615:The Cochrane Database of Systematic Reviews
560:
558:
519:The Cochrane Database of Systematic Reviews
417:
415:
223:Cement in a vertebra as seen on plain Xray.
2063:
1830:
1798:
1784:
1776:
1452:
1450:
1261:
1259:
1257:
1216:, American Academy of Orthopaedic Surgeons
488:Centers for Medicare and Medicaid Services
476:
474:
40:
2191:Anterior cruciate ligament reconstruction
1588:
1547:
1537:
1395:
1283:
1183:
1173:
1053:
1008:
915:
819:
642:
585:
538:
2143:Ulnar collateral ligament reconstruction
1577:AJNR. American Journal of Neuroradiology
1526:AJNR. American Journal of Neuroradiology
277:American Academy of Orthopaedic Surgeons
1571:Cloft, HJ; Jensen, ME (February 2007).
1314:. April 2013. p. 3. Archived from
481:Noridian Administrative Services, LLC.
399:
1108:continues over value of vertebroplasty
239:useful for differentiating coverage."
31:
7:
1168:(online first): bmjebm–2019–111171.
574:Journal of Bone and Mineral Research
207:guidance. The cement (most commonly
2049:Autologous chondrocyte implantation
1110:. Diagnostic Imaging. 2010;32(2) 5.
163:"molded, formed") and the prefixes
76:
2200:Unicompartmental knee arthroplasty
2044:Knee cartilage replacement therapy
861:10.5694/j.1326-5377.2010.tb03533.x
25:
178:"joint, joint of the spine") and
1388:10.1111/j.1757-7861.2012.00193.x
942:Journal of Clinical Neuroscience
849:The Medical Journal of Australia
437:Expert Review of Medical Devices
1493:Springer Science+Business Media
812:10.1001/jamainternmed.2013.8725
686:10.1016/j.maturitas.2012.02.010
2303:Orthopedic surgical procedures
1459:"Squandering Medicare's Money"
1457:REDBERG, Rita (May 25, 2011).
627:10.1002/14651858.CD006349.pub4
531:10.1002/14651858.CD006349.pub4
1:
2308:Bones of the vertebral column
766:10.1016/S0140-6736(09)60010-6
1672:10.1097/BRS.0000000000000992
385:In 2015, it was reported by
1733:Kolata, Gina (2019-01-24).
1162:BMJ Evidence-Based Medicine
896:BMJ (Clinical Research Ed.)
105:spinal procedures in which
35:Percutaneous vertebroplasty
18:Percutaneous vertebroplasty
2329:
2032:Articular cartilage repair
1615:Osteoporosis International
1175:10.1136/bmjebm-2019-111171
1135:10.1016/j.jvir.2009.04.022
954:10.1016/j.jocn.2011.12.015
198:interventional radiologist
1815:
1627:10.1007/s00198-012-2100-0
1433:10.1148/radiol.2431060045
1340:Acta Orthopaedica Belgica
721:10.1007/s00270-010-9901-3
407:Oxford English Dictionary
77:
39:
2313:Interventional radiology
2158:Finger joint replacement
1949:Distraction osteogenesis
209:poly methyl methacrylate
27:Type of spinal procedure
1700:Pinsker, Story by Joe.
288:Vertebral body stenting
1939:Femoral head ostectomy
1907:Vertebral augmentation
800:JAMA Internal Medicine
303:
224:
117:caused by a vertebral
91:Vertebral augmentation
2136:Weaver–Dunn procedure
2037:Microfracture surgery
1806:Procedures involving
1285:10.1093/ageing/afs024
1055:10536/DRO/DU:30019842
1046:10.1056/NEJMoa0900429
1001:10.1056/NEJMoa0900563
301:
222:
2126:Shoulder replacement
2088:Intervertebral discs
1846:Orthognathic surgery
1129:(7 Suppl): S326–31.
119:compression fracture
113:in order to relieve
101:, refers to similar
2278:Arthroscopic lavage
2010:Tension band wiring
1376:Orthopaedic Surgery
346:Society and culture
250:vertebral fractures
146:classical compounds
121:. After decades of
2220:Triple arthrodesis
2215:Broström procedure
2153:Brunelli procedure
1954:Ilizarov apparatus
1902:Vertebral fixation
1818:Orthopedic surgery
1739:The New York Times
1539:10.3174/ajnr.A2502
304:
225:
205:fluoroscopic x-ray
2290:
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2256:Joint replacement
2210:Ankle replacement
2018:
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2005:External fixation
2000:Internal fixation
1851:Chin augmentation
1506:978-0-387-29078-2
908:10.1136/bmj.d3952
760:(9668): 1016–24,
587:10.1002/jbmr.3653
450:10.1586/erd.12.27
365:Medicare response
169:"vertebra" (from
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2196:Knee replacement
2121:Shoulder surgery
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81:edit on Wikidata
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2271:Arthrocentesis
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2186:Rotationplasty
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2039:
2028:
2026:
2020:
2019:
2016:
2015:
2013:
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1997:
1992:
1990:Epiphysiodesis
1987:
1982:
1977:
1971:
1969:
1965:
1964:
1962:
1961:
1956:
1951:
1946:
1944:Astragalectomy
1941:
1935:
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1929:
1928:
1926:
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1909:
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1764:External links
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1621:(4): 1437–45.
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1463:New York Times
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1272:Age and Ageing
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1088:(4): E515–22.
1082:Pain Physician
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255:selection bias
244:
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193:
192:Vertebroplasty
190:
148:of the suffix
134:Vertebroplasty
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1980:Bone grafting
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270:extravasation
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243:Effectiveness
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156:Ancient Greek
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152:
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142:medical terms
139:
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100:
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92:
82:
72:
68:
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30:
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2260:
2241:Arthroplasty
2205:Ankle fusion
2148:Hand surgery
2103:Arthroplasty
2098:Annuloplasty
1906:
1897:Foraminotomy
1882:Laminoplasty
1867:Coccygectomy
1750:. Retrieved
1738:
1728:
1717:. Retrieved
1706:The Atlantic
1705:
1695:
1663:
1657:
1651:
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1580:
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1466:. Retrieved
1462:
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1379:
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1343:
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1320:. Retrieved
1316:the original
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496:. Retrieved
486:
441:
435:
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387:The Atlantic
386:
384:
368:
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340:spinal tumor
337:
333:percutaneous
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246:
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188:"crooked").
183:
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164:
158:
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103:percutaneous
98:
94:
93:, including
90:
89:
29:
2251:Arthroscopy
2246:Synovectomy
2076:Arthrodesis
1892:Facetectomy
1877:Laminectomy
1495:. pp.
680:(1): 42–9.
580:(1): 3–21.
371:US Medicare
215:Kyphoplasty
138:kyphoplasty
107:bone cement
99:kyphoplasty
65:MedlinePlus
2297:Categories
2266:Arthrogram
2236:Arthrotomy
2093:Discectomy
1887:Corpectomy
1872:Laminotomy
1810:and joints
1752:2020-05-26
1719:2020-05-26
1468:18 January
498:18 October
394:References
374:contractor
315:Prevalence
2024:Cartilage
1995:Reduction
1985:Osteotomy
1975:Ostectomy
1772:NYTs 2019
1747:0362-4331
1714:1072-7825
1421:Radiology
902:: d3952.
674:Maturitas
635:1469-493X
381:Promotion
166:vertebro-
129:Procedure
115:back pain
2261:imaging:
1688:20164158
1680:26020845
1643:22020223
1635:22872070
1599:17296979
1558:21546460
1441:17392252
1406:22927153
1352:22696994
1322:17 March
1294:22417981
1194:30852489
1143:19560019
1106:Moan R.
1094:22828697
1064:19657121
1019:19657122
962:22595547
926:21750078
877:12672714
869:20230351
830:23836009
782:12241054
774:19246088
737:25901532
729:20523998
694:22425141
653:30399208
596:30677181
549:30399208
458:22905846
358:balloons
233:vertebra
229:kyphosis
175:vertebra
111:vertebra
53:ICD-9-CM
2229:General
1968:General
1590:7977394
1549:7966060
1397:6583132
1185:7286037
1010:2930487
970:8301676
917:3133975
821:4023124
644:6517304
540:6517304
466:6448288
323:History
160:plastós
151:-plasty
2059:Joints
1745:
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263:cancer
185:kyphos
180:kypho-
71:007512
2068:Spine
1860:Spine
1826:Bones
1808:bones
1684:S2CID
1659:Spine
1639:S2CID
1238:(PDF)
1214:(PDF)
966:S2CID
873:S2CID
778:S2CID
733:S2CID
462:S2CID
409:2009.
171:Latin
79:[
58:81.65
1834:Face
1743:ISSN
1710:ISSN
1676:PMID
1631:PMID
1595:PMID
1554:PMID
1501:ISBN
1499:–5.
1470:2013
1437:PMID
1402:PMID
1348:PMID
1324:2015
1290:PMID
1242:ISBN
1190:PMID
1139:PMID
1090:PMID
1060:PMID
1015:PMID
958:PMID
922:PMID
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826:PMID
770:PMID
725:PMID
690:PMID
649:PMID
631:ISSN
619:2018
592:PMID
545:PMID
523:2018
500:2011
454:PMID
351:Cost
144:are
136:and
97:and
2169:Leg
2114:Arm
1932:Leg
1916:Arm
1668:doi
1623:doi
1585:PMC
1544:PMC
1534:doi
1429:doi
1425:243
1392:PMC
1384:doi
1280:doi
1180:PMC
1170:doi
1131:doi
1050:hdl
1042:doi
1038:361
1005:PMC
997:doi
993:361
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912:PMC
904:doi
900:343
857:doi
853:192
816:PMC
808:doi
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
