Effectiveness of spinal fracture procedure called into question

20 Apr 2018

The effectiveness of the medical procedure vertebroplasty - for repairing spinal fractures - has been in the spotlight recently, after a scientific review concluded it provides little benefit for patients.

Vertebroplasty involves injecting medical-grade cement into a fractured vertebra through a needle, under light sedation or general anaesthesia.

The procedure has been widely used to treat osteoporotic vertebral fractures, but now a new Cochrane review of existing evidence has said it has no beneficial effect, and may even cause harm.

“There is now high quality evidence that there are no clinically important benefits over a placebo (fake) procedure, although there is potential to cause harm,” said lead author of the review Professor Rachelle Buchbinder.

However, the findings of the new review differ from recommendations from health watchdog the National Institute for Health and Care Excellence (NICE), which recommends the procedure in certain circumstances, including for people with severe pain and with unhealed vertebral fractures.

Ali Doyle, Head of Clinical Practice at the National Osteoporosis Society said the Cochrane review was an interesting addition to general understanding of vertebroplasty.

“While these are interesting findings, they do illustrate that more research is needed in this area. NICE does still recommend the procedure and health professionals and their patients should approach vertebroplasty very much on an individual basis.”

Dr Nicola Peel, Metabolic Bone Centre Consultant and Clinical Lead  at the 
Northern General Hospital in Sheffield said the review provided "further evidence that questions the value of undertaking vertebroplasty."

However, Dr Peel also pointed out that "many clinicians still believe it is worthwhile to consider this procedure in a subgroup of patients with severe pain that can be shown to be associated with an unhealed vertebral fracture and which has not been adequately controlled using standard approaches to pain management."

"Whilst vertebroplasty may not alter longer-term outcomes, it may enable more rapid rehabilitation, and is particularly pertinent when symptoms have led to hospital admission," she added. 

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