Percutaneous vertebroplasty effective / safe in acute osteoporotic vertebral compression fractures

January 01, 0001

Percutaneous vertebroplasty effective / safe in acute osteoporotic vertebral compression fractures

The researchers aimed to clarify whether vertebroplasty has additional value compared with optimum pain treatment in patients with acute vertebral fractures. Patients were recruited to this open-label prospective randomised trial from the radiology departments of six hospitals in the Netherlands and Belgium. Patients were aged 50 years or older, had vertebral compression fractures on spine radiograph (minimum 15% height loss; level of fracture at Th5 or lower; bone oedema on MRI), with back pain for 6 weeks or less, and a visual analogue scale (VAS) score of 5 or more. Patients were randomly allocated to percutaneous vertebroplasty or conservative treatment . Between Oct 1, 2005, and June 30, 2008, they enrolled 202 patients.

Vertebroplasty resulted in greater pain relief than did conservative treatment; difference in mean VAS score between baseline and 1 month was -5.2 after vertebroplasty and -2.7 after conservative treatment, and between baseline and 1 year was -5.7 after vertebroplasty and -3.7 after conservative treatment. The difference between groups in reduction of mean VAS score from baseline was 2.6 at 1 month and 2.0 at 1 year (both significant). No serious complications or adverse events were reported.

The researchers concluded: "In a subgroup of patients with acute osteoporotic vertebral compression fractures and persistent pain, percutaneous vertebroplasty is effective and safe. Pain relief after vertebroplasty is immediate, is sustained for at least a year, and is significantly greater than that achieved with conservative treatment, at an acceptable cost."

It looks as though patient selection is important.

For the full abstract, click here.

The Lancet published online 10 August 2010 © 2010 Elsevier Ltd
Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Caroline AH Klazen, Paul NM Lohle, Jolanda de Vries et al. Correspondence to Caroline AH Klazen: [email protected]

Category: M. Musculoskeletal. Keywords: ertebroplasty, conservative, treatment, acute, osteoporotic, fractures, open-label randomized trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 27 August 2010

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