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Vertebroplasty No Better Than Sham Procedure in Osteoporotic Fractures

Two placebo-controlled trials of vertebroplasty find no added benefit in pain relief or quality of life. The studies appear in the New England Journal of Medicine.

In both studies, patients with painful osteoporotic vertebral fractures underwent randomization to either vertebroplasty or a sham procedure.

Among some 80 Australian patients in the first study, there were no differences between the groups in overall pain improvement at the 3-month mark, the primary outcome measure.

Similarly, in the second study, some 130 patients from the U.S., U.K., and Australia underwent randomization and subsequent follow-up for clinical improvement at the 1-month mark. Again, no significant differences were found.

An editorialist says the results may consign vertebroplasty to being considered "no better than placebo." And in Journal Watch General Medicine, Dr. Allan S. Brett writes that unless studies can identify a subgroup of patients who benefit from it, the procedure "should be viewed skeptically."

LINK(S):

NEJM article 1 (Free abstract; full text requires subscription)

NEJM article 2 (Free abstract; full text requires subscription)

NEJM editorial (Free)

Journal Watch General Medicine summary (Your Journal Watch subscription required)

Published in Physician's First Watch August 6, 2009