Is vertebroplasty efficacious for severe or recent pain?

January 01, 0001

Is vertebroplasty efficacious for severe or recent pain?

The efficacy of vertbroplasty in treating pain from compression fractures has been called into question. However, it has been proposed that it may be beneficial in case of severe pain or pain of recent onset. These Australian and US researchers examined vertebroplasty in these subgroups using a meta-analysis of combined individual patient level data from two multicenter randomized placebo-controlled trials (n=209) involving 57 patients with pain of recent onset (<6 weeks) and 99 with severe pain (8 or more on a 10 scale).

The researchers found: "For participants with pain of recent onset, between group differences in mean change scores at one month for pain and disability were 0.1 and 0.2, respectively. For participants with severe pain at baseline, between group differences for pain and disability scores at one month were 0.3 and 1.4, respectively. At one month those in the vertebroplasty group were more likely to be using opioids."

The researchers concluded: "Individual patient data meta-analysis from two blinded trials of vertebroplasty, powered for subgroup analyses, failed to show an advantage of vertebroplasty over placebo for participants with recent onset fracture or severe pain. These results do not support the hypothesis that selected subgroups would benefit from vertebroplasty."

This study find no evidence that vertebroplasty is efficacious for compression fracture pain, even in cases of recent onset or severe pain.

For the full abstract, click here.

BMJ 342:d3952, 12 July 2011 © 2011 BMJ Publishing Group Ltd.
Effectiveness of vertebroplasty using individual patient data from two randomised placebo controlled trials: meta-analysis. Margaret P Staples, David F Kallmes, Bryan A Comstock, et al. Correspondence to R Buchbinder: [email protected]

Category: M. Musculoskeletal. Keywords: vertebroplasty, compression fracture, pain, recent, severity, meta- analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 5 August 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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