Vertebroplasty, kyphoplasty and sacroplasty

Vertebroplasty involves injection of bone cement into a partially collapsed vertebral body, while kyphoplasty involves expansion of the partially collapsed vertebral body with an inflatable bone tamp, in an effort to relieve pain and provide stability. Sacroplasty involves surgical treatment that attempts to repair sacral insufficiency fractures using bone cement.

Vertebroplasty, kyphoplasty, and sacroplasty, (VKS) was first reviewed by the HTA program in 2011.

  • In 2016, an update literature review of VKS research was conducted to determine if newly available evidence published since 2011 was likely to change the original coverage determination. The technology was not selected for rereview.
  • In 2017, a supplement to the 2016 literature review was published. The technology was not selected for rereview.
  • In 2020, a second update literature review was conducted to determine if evidence published since 2017 was likely to change the original determination. The technology was not selected for rereview.
  • In 2023, the HCA director selected VKS for rereview based on newly available evidence published which could change the original coverage determination.

Status: Decision completed

Why is VKS being reviewed?

These surgical procedures are less invasive than other spinal surgical procedures, but more invasive than conservative medical therapy. Significant questions remain about the safety, efficacy, effectiveness (particularly long term and appropriate selection and therapy phase), and the cost effectiveness of vertebroplasty, kyphoplasty, and sacroplasty.

Primary criteria ranking

  • Safety = Medium
  • Efficacy = Medium
  • Cost = Medium


Type Materials
Update literature (2020)
Update literature supplement (2017)
Update literature (2016)
Assessment (2010)

* Due to file size, Appendix 2 is only available by request

Assessment timeline (2010)

  • Draft report published: October 7, 2010
    • Public comment period: October 7 to October 22, 2010
  • Final report published: November 5, 2010
  • HTCC public meeting: December 10, 2010