Vertebroplasty is no more effective for pain relief than a sham procedure in older patients with osteoporosis, finds a trial published by The BMJ.
The researchers say 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. 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 one to three 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 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 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.
The mean reduction in VAS