For the first time, the American Academy of Orthopaedic Surgeons (AAOS) has released a clinical practice guideline that strongly discourages the use of vertebroplasty as a method for treating spine fractures.
An AAOS workgroup reviewed several years of research on vertebroplasty and concluded that the surgical procedure "does not offer any advantages" when compared to a placebo control group.
Vertebroplasty is a surgical procedure developed to reduce or eliminate the pain associated with compression fractures of the spinal vertebrae. The procedure involves injecting bone cement under imaging guidance into the vertebrae to stabilize fractures.
Orthopedic surgeon Stephen Esses, MD, chair of the AAOS workgroup that developed the guideline, said the recommendation against the procedure is largely based on two randomized, controlled clinical trials that were published in the New England Journal of Medicine.
The studies compared vertebroplasty and a sham procedure and reported "no statistically significant difference between the two procedures in pain." The workgroup also reviewed the published criticisms of the two trials and found the criticisms were not supported by existing evidence.
For those patients who have had vertebroplasty, Esses said that when the patients received this procedure, vertebroplasty was thought to alleviate spinal compression fractures and was perceived as beneficial.
He added that surgery is not the answer for everything, and there are a variety of other treatments, such as medications or nerve blocks, that can ease the pain of spinal fractures.
The full guideline and supporting documentation and workgroup disclosures are available here.
Related Reading
Radiologists and surgeons fractured over vertebroplasty vs. kyphoplasty, November 18, 2003
FDA urges caution with off-label use of bone cement in vertebroplasty, April 7, 2003
New vertebral fractures often occur following percutaneous vertebroplasty, February 25, 2003
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