Bone health

No evidence for vertebroplasty: Cochrane

There is no evidence to support a role for vertebroplasty for treating osteoporotic vertebral fractures in routine practice, a Cochrane review confirms.

The Musculoskeletal Group’s review of the evidence found no “demonstrable clinically important benefits compared with a sham procedure”.

A subgroup analyses indicated that results did not differ according to duration of pain ≤ 6 weeks versus > 6 weeks. Sensitivity analyses confirmed that open trials comparing vertebroplasty with usual care are likely to have overestimated any benefit of vertebroplasty.

“Correcting for these biases would likely drive any benefits observed with vertebroplasty towards the null, in keeping with findings from the placebo-controlled trials,” the review authors said.

Due to a small number of adverse events the group could not be certain about whether or not vertebroplasty results in a clinically important increased risk of new symptomatic vertebral fractures or other serious adverse events.

Nevertheless patients should be informed about both the lack of high quality evidence supporting benefit of vertebroplasty and its potential for harm, they concluded.

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