Review finds vertebroplasty ineffective

A research review adds to evidence against injecting medical cement - a procedure known as vertebroplasty, to repair spinal fractures caused by osteoporosis.

Using medical-grade cement to repair painful spinal fractures caused by osteoporosis provides little benefit and may even cause harm, a Cochrane Review has found.

The review, published on Thursday, is the latest study to cast doubt on the contentious role of vertebroplasty - a surgical procedure that involves injecting cement through a small hole in the skin into a fractured vertebra - in the treatment of osteoporotic vertebral fractures.

Osteoporosis is a common disease in Australia, with 1.2 million people estimated to have the condition that turns bones brittle, leading to a higher risk of fractures or breaks than in a normal bone.

A medical trial published in the New England Journal of Medicine in 2009 found vertebroplasty had no beneficial effect.

Professor Rachelle Buchbinder, Director of the Monash Department of Clinical Epidemiology, Cabrini Institute led the Cochrane Review and says over the past 10 years the evidence against vertebroplasty has continued to build.

"We now have high quality evidence based on a larger number of trials and participants that there are no clinically important benefits for patients over placebo, and there is potential to cause harm," she said.

The latest Cochrane Review included 21 trials involving 2,862 participants and of these there were five trials that compared vertebroplasty to placebo involving 541 participants.

Geriatrician and bone biologist Professor Gustavo Duque at the Australian Institute for Musculoskeletal Science says vertebroplasty has typically been reserved for patients with high levels of pain who do not respond to conservative non-surgical management.

It is a common procedure in some European countries and according to Professor Duque just a few centres in Australia perform it on a regular basis.

The expert, who is also Chair of Medicine - Western Health, University of Melbourne University, said he was not surprised that the Cochrane Review found vertebroplasty to be ineffective.

"Most of the few well designed randomised placebo controlled trials in this field have demonstrated that vertebroplasty is not effective. In a couple of those studies, the placebo showed a better effect," Professor Duque said.

Source AAP

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