Starting July 1, 2022, vertebral bone cement is covered by NHI; NHI will cover 1 set (pack) per operation, which will benefit about 4,300 patients yearly.
Vertebral compression fractures (VCFs) are fractures that occur when the bony block or vertebral body in the spine collapses. Such fractures may lead to severe pain, deformity, or even loss of height. VCFs commonly occur in the thoracic spine. The main clinical symptoms of compression fractures of the thoracic and lumbar spine include persistent pain, hunchback, nerve damage, and even difficulty breathing; they often lead to back pain or deformity in the elderly, but prolonged bed rest is actually more likely to cause accelerated bone loss in such patients, resulting in loss of function or even adversely affecting life.
The goal of treating VCFs is to restore spinal stability, reduce pain, and restore mobility. Rather conservative treatments, such as bed rest, painkillers, back frames, and physical therapy, essentially wait for the fracture to heal naturally, which will relieve pain. However, if there are prominent symptoms, such as nerve compression, severe pain, and weakness, surgery is recommended. Traditional surgical methods include nerve decompression surgery or combined spinal fusion and bone screws. However, most patients have osteoporosis, and the steel screws are placed on the weaker bones, meaning a poor stabilization effect. In addition, due to its long operative and healing time, elderly patients or patients with other chronic diseases are more prone to complications.
Dr. Po-Chang Lee, Director General of the NHIA, said that based on the Study on the Payment-Effectiveness of Orthopedic Medical Devices and the health technology assessment report and considering vertebroplasty for reconstructing spine stability, the vertebral bone cement used for pain relief is more obvious efficacy compared with the bone cement originally provided by NHI. The vertebral bone cement possesses a high viscosity at low temperature, and reduces the occurrence of complications, making patients much safer by reducing the possibilities of further operations and occurrence of infection, as well as shortening the length of hospital stays. This is especially important for compressive vertebral body fractures caused by osteoporosis, when vertebral bone cement is clinically necessary.