Trends in Vertebral Augmentation in South Korea (2010-2024): A Nationwide Population-Based Study With International Comparison.

Abstract

Vertebral augmentation (VA)-vertebroplasty (VP) and balloon kyphoplasty (BKP)-treats painful osteoporotic vertebral compression fractures refractory to conservative care. After 2009 sham-controlled trials, US VA use declined and shifted toward BKP; long-term Korean trends are less defined. To evaluate national VA utilization in South Korea from 2010 through 2024 and compare it with international patterns. Nationwide serial cross-sectional study of public HIRA aggregate statistics (2010-2024). Annual N0471 (VP) and N0473 (BKP) code-specific patient counts; the 15-year cumulative sum was 643,255. Counts could not be deduplicated across years or procedure categories. Annual procedure, sex, age, regional, average annual percent change (AAPC), and nominal claim-amount trends. Descriptive summaries and log-linear regression were used; international comparisons were narrative. Funding was US$0; relevant financial relationships were US$0, and no study-specific conflict-of-interest-associated bias was identified. The national annual count increased from 30,190 to 59,556 (+97.3%; AAPC +4.4%; p<0.001). VP rose from 24,165 to 54,364 (AAPC +5.2%; p<0.001), and its share increased from 80.0% to 91.3%. BKP ended 13.8% lower (6,025 to 5,192), with a nonsignificant trend (AAPC -0.7%; p=0.260). Females comprised 80.6%-82.6% of annual counts. The group aged 80 years or older reached 54.3% of counts in 2024 (AAPC +9.8%; p<0.001). Nominal HIRA-adjudicated claim amounts increased from KRW 9.679 billion to KRW 19.041 billion (+96.7%; AAPC +4.6%; p<0.001). South Korea showed sustained VP-predominant growth, unlike US practice, and a marked shift toward patients aged 80 years or older, with planning implications in a super-aged society.