Percutaneous Vertebroplasty: a History of Procedure, Technology, Culture, Specialty, and Critical Economics

Keywords: vertebroplasty, health care, review, History, technique

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     Progression of surgical technology is the result of many factors, and a better procedure adoption is often not the result of only totally defined efficacy or rational determinations. Such advancement is often associated with ideals of imagination to develop ground-breaking and life-saving techniques and known positive effect. Often neglected are social, economic, marketing, engineering-materials, relationships to specialty, and regulatory contexts, as well as whether there is confirmation of efficacy.
     Percutaneous vertebroplasty (PV) became one of the fastest emerging techniques in spine surgery.
     PV provides a historically fascinating case study into a rapidly adopted procedure which had significant impact upon the direction of spinal surgery and became an often critically cited example for comparative-effectiveness research. PV was the synthesis of information gained from spinal biopsy developments, inception of biomaterials use in surgery, and unique healthcare climate within France and the US. Designed as a revolutionary technique, PV was determined to safely and effectively treat vertebral body fractures with minimal side effects experienced by the patient, and was rapidly adopted and marketed in the US.
     Development of kyphoplasty, a variant procedure, is one of the few procedures in medicine that was totally patented, i.e., instruments and procedure, and linked directly to a company.
     This is a retrospective review.
     Seized upon as the gateway into relatively uncomplicated spine surgery by several medical specialties, PV provides a fascinating case history into what may be rational or irrational aspects of the adoption of a surgical procedure.
     Nevertheless, the development of PV stands at the vanguard of percutaneous spinal surgery procedures.


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