Vertebroplasty is a medical spinal procedure where bone cement is injected through a small hole in the skin (percutaneously) into a fractured vertebra with the goal of relieving the pain of osteoporotic compression fractures.
It has been found to be ineffective in treating compression fracture of the spine.
Some of the associated risks that can be produced are from the leak of
acrylic cement outside of the vertebral body. Although severe
complications are extremely rare, it is important to know that
infection, bleeding, numbness, tingling, headache, and paralysis may
ensue due to misplacement of the needle or cement. This particular risk
is decreased by the use of x-ray or other radiological imaging to ensure
proper placement of the cement.
Two studies published in ''The New England Journal of Medicine'' found no benefit to vertebroplasty:
- In a multicenter, randomized, double-blind,
placebo-controlled trial involving 131 participants who were patients
with one or two painful osteoporotic vertebral fractures, vertebroplasty
did not result in greater improvement than a sham procedure in overall
pain, physical functioning, or quality of life at 3 or 6 months after
treatment. Jeffrey Jarvik of the University of Washington said his
study, funded by the National Institutes of Health, found vertebroplasty
had no detectable benefit when compared with procedures that only
mimicked such procedures. He advises that "vertebroplasty should not be
done any longer, unless it's in the setting of a study.
- In a randomized trial involving 78 participants with
osteoporotic vertebral ''compression fractures'', patients who underwent
vertebroplasty had improvements in pain and disability measures that
were similar to those in patients who underwent a sham procedure.
University of Virginia radiologist Avery Evans said his study, which was
funded by the Australian government and Cook Medical Inc., found
vertebroplasty and sham procedures offered patients nearly identical
pain relief. Additionally, there has been criticism that the "sham" or
"placebo" procedure performed in the studies would be more appropriately
classified as an alternative procedure in that there was, in fact,
surgical intervention around the vertebra. and many vertebroplasty
practitioners continue to advocate for the procedure. However, none of
the other studies had the benefit of double-blind comparisons against
placebos and randomized samples of patients.
Further Reading
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"Vertebroplasty"
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