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Percutaneous vertebroplasty is not
advised for acute osteoporotic vertebral compression
treatment.
Percutaneous vertebroplasty may not be a more efficient than Sham procedure to relieve pain in patients with acute osteoporotic vertebral compression fractures. The results of 2 months' follow-up suggest the same. The study was carried to compare the efficiency of both procedures.
Cristina E Firanescu et al. performed a randomised, double-blind, sham-controlled clinical trial set in 4 community hospitals in the Netherlands from 2011 to 2015. Total of 180 participants who need the treatment for acute osteoporotic vertebral compression fractures was randomised to either vertebroplasty in 91 participants or a sham procedure in 89 participants. At each pedicle, the participants received local subcutaneous lidocaine (lignocaine) and bupivacaine. The vertebroplasty group also received cementation, simulated in the sham procedure group. The primary study outcomes were the mean reduction in VAS at first week and monthly follow up at 1,3,6, 12 months. A decrease of 3 points in VAS scores from baseline was designated as clinically significant pain relief. The secondary outcomes were changes in QoL for osteoporosis patients and Roland-Morris disability questionnaire for 12 months follow-up. A statistically significant difference in VAS from the baseline was observed in the vertebroplasty and sham procedure. Whereas no notable difference was seen in the secondary outcomes. No statistically significant differences between the groups were perceived as the use of analgesics reduced significantly in both groups at all time points. The vertebroplasty group had two adverse events: vasovagal reaction and respiratory insufficiency.
Thus the percutaneous vertebroplasty cannot be used as an efficient management option for osteoporotic vertebral compression fractures.
BMJ
Vertebroplasty versus sham procedure for painful acute osteoporotic vertebral compression fractures (VERTOS IV): randomised sham controlled clinical trial
Cristina E Firanescu et al.
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