Standards of Practice
Position Statement on Percutaneous Vertebral Augmentation: A Consensus Statement Developed by the Society of Interventional Radiology (SIR), American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS), American College of Radiology (ACR), American Society of Neuroradiology (ASNR), American Society of Spine Radiology (ASSR), Canadian Interventional Radiology Association (CIRA), and the Society of NeuroInterventional Surgery (SNIS)

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Vertebral Augmentation versus Nonoperative Medical Treatment

Nonoperative medical treatment of VCFs has often been described as “conservative” or “traditional” management. As we have stated previously, although “conservative” implies “safe,” such therapy is neither benign nor risk-free, and its complications are well documented (98, 99, 100). Nonoperative medical treatment of painful VCFs usually consists of bedrest, bracing, and narcotic analgesia. In a prospective study of 498 hospitalized patients age 70 years or older (97), low mobility (defined as

Conclusions

It is the position of the Societies that PVA remains a proven medically appropriate therapy for treatment of painful VCFs refractory to nonoperative medical therapy and for vertebrae weakened by neoplasia when performed for the medical indications outlined in the published standards (1, 2, 3, 4).

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    The initial version of this document first appeared in J Vasc Interv Radiol 2007; 18:325–330 and 2009; 20(suppl):S326–S331.

    J.D.B. owns shares in Spine Wave (Shelton, Connecticut). J.K.M. receives royalties from Cook (Bloomington, Indiana) and owns stock in Dfine (San Jose, California). A.L.B. is a paid consultant for DePuy (Raynam, Massachusetts). J.E.O. is a paid consultant for and receives royalties from Globus Medical (Audubon, Pennsylvania) and Pioneer Surgical (Marquette, Michigan). T.C.R. is a paid consultant for Medtronic (Minneapolis, Minnesota) and Arbor Pharmaceuticals (Atlanta, Georgia). S.M.T. is a paid consultant for Benvenue Medical (Santa Clara, California). None of the other authors have identified a conflict of interest.

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