Study found spinal surgery as effective as a sham procedure in reducing pain in older patients with osteoporosis
Surgery to repair spinal fractures does not work in patients with brittle bones. In fact a new study published in The BMJ has found that Vertebroplasty is no more effective for pain relief than a sham (placebo) procedure in older patients with osteoporosis.
Researchers said their results “do not support vertebroplasty as standard pain treatment in patients with osteoporotic vertebral fractures.”
Vertebroplasty involves injecting a special cement into the fractured bone to stabilise it and to relieve pain
Osteoporosis is a disease in which bones become weak and more likely to break. Fractures caused by osteoporosis most often occur in the spine and are called vertebral compression fractures. Long term, these fractures can lead to deformity, breathing problems, and loss of height.
Vertebroplasty involves injecting a special cement into the fractured bone to stabilise it and to relieve pain. But previous studies have reported conflicting results and there is ongoing debate about its benefits, risks, and cost-effectiveness.
To try to resolve this uncertainty, researchers in the Netherlands and the USA compared pain relief in patients undergoing vertebroplasty or a ‘sham’ procedure, where patients are given local anaesthetic injections, but no bone cement.
The trial involved 180 adults aged older than 50 years, with 1-3 painful vertebral compression fractures of up to nine weeks old. Participants were randomly assigned to either vertebroplasty (91 patients) or the sham procedure (89 patients).
The main (primary) outcome measure was mean reduction in pain scores at one day, one week, and one, three, six, and 12 months after the procedure. Other (secondary) outcomes were differences in quality of life and disability over 12 months.
Pain was measured using a visual analogue scale (VAS) ranging from 0 (no pain) to 10 (severe pain). Clinically significant pain relief was defined as a decrease of 1.5 points in VAS score from the start of the study (baseline).
“Percutaneous vertebroplasty to treat patients with acute osteoporotic vertebral compression fractures did not result in statistically significant more pain relief than a sham procedure during 12 months’ follow-up,” the researchers said.
