Vertebroplasty No Better Than Placebo For Spinal Fracture Pain: Study

The findings of a new study suggest that a common surgical procedure for spinal fractures, known as a vertebroplasty, may be no better than a placebo at alleviating pain.

Researchers from the Netherlands warn that vertebroplasty is no better at improving pain and should not be the standard of care the surgical procedure is now considered.

The study was published earlier this month in the medical journal The BMJ, involving a randomized, double blind controlled trial with 180 patients over 50, who had one to three osteoporotic vertebral compression fractures that were up to nine weeks old. Some patients received the vertebroplasty procedure, and others in a control group underwent a fake procedure.

During vertebroplasty, doctors inject polymethylmethacrylate, a special kind of cement, into the fractured vertebra to try to stabilize the fracture and the pain. Control patients were given a local anesthetic and a fake procedure, but no cement was used.

During the study at four community hospitals in the Netherlands pain levels were tracked from day one, the first week after the procedure, then at one, three, six and 12 month followups. But overall, both patients experienced similar pain levels.

Overall, patients who had vertebroplasty and control patients who did not have the procedure experienced similar levels of pain relief. The findings indicate the procedure did not improve a person’s levels of pain. There was also no improvement of quality of life, or in reducing disability among patients.

Osteoporosis compression fractures most commonly occur in the spine. They can cause severe pain, spinal deformity, breathing problems, loss of height, and increased morbidity.

Prior studies focusing on vertebroplasty have shown mixed results. Some have indicated the procedure offers reduced pain for patients. Other studies have shown no effect.

A study from 2009 found there was no short term benefit to vertebroplasty compared to no procedure. Yet, studies from 2010 and 2016 showed improved pain relief and more pain free days.

Because of the prior findings, vertebroplasty became a standard pain treatment for patients with osteoporotic spinal fractures. It is a commonly suggested procedures by doctors.

Researchers of the new study say vertebroplasty should not be a standard pain treatment for patients with spinal fractures. Too many studies indicate the procedure may have no effect on a patient’s pain. Thus, patients considering the procedure should be informed of the lack of effectiveness and potential complications before undergoing it.