About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Osteoporosis Pain Treatment: Spinal Surgery No Better Than Injections

by Thilaka Ravi on May 10, 2018 at 3:43 PM
Font : A-A+

Osteoporosis Pain Treatment: Spinal Surgery No Better Than Injections

Surgery to repair spinal fractures known as vertebroplasty, is no more effective for pain relief than a sham (placebo) 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."

Advertisement


Osteoporosis is a disease in which bones become weak and more likely to break. Fractures caused by osteoporosis most often occur in the spine and are called vertebral compression fractures. Long term, these fractures can lead to deformity, breathing problems, and loss of height.

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.
Advertisement

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 anesthetic injections, but no bone cement.

The trial involved 180 adults aged older than 50 years, with 1-3 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 main (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 (secondary) 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 (baseline).

The mean reduction in VAS pain score was statistically significant in both groups at all follow-up points after the procedure, compared with baseline. However, these changes in VAS scores did not differ significantly between the groups over the 12 month follow-up period.

Vertebroplasty had no effect on quality of life or on disability.

"Percutaneous vertebroplasty to treat patients with acute osteoporotic vertebral compression fractures did not result in statistically significant more pain relief than a sham procedure during 12 months' follow-up," say the researchers.

They point to some study limitations, such as lack of an untreated control group and limited generalisability to other treatments. However, strengths over previous trials included larger patient groups and longer follow-up.

They believe there is a place for vertebroplasty "when efficacy outweighs the risks," but conclude that these results "do not support using percutaneous vertebroplasty as standard pain treatment in patients with acute osteoporotic vertebral compression fractures."

This trial suggests that vertebroplasty "should not be offered to patients with three or fewer painful osteoporotic vertebral fractures of less than 6-9 weeks' duration," says Evan Davies, consultant spinal surgeon at Southampton General Hospital, in a linked editorial.

However, questions remain on its place in the management of chronic painful fractures, and, more specifically, whether cement augmentation has any role in the prevention of long term morbidity and mortality, he adds.

These are fruitful areas for further research, he writes, In the meantime, early vertebroplasty - before nine weeks - "should probably be considered only in exceptional circumstances for patients with vertebral osteoporotic fractures."

Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Advertisement
News Category
What's New on Medindia
International Day of Persons with Disabilities 2021 - Fighting for Rights in the Post-COVID Era
Effect of Blood Group Type on COVID-19 Risk and Severity
Woman with Rare Spinal Cord Defect from Birth Sues Doctor
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Fracture Rickets Osteoporosis Lifestyle And Osteoporosis Kyphosis Colle’s Fracture Fracture Neck of Femur Back Pain at Workplace: Prevention and Exercises Screening for Osteoporosis Bone Health 

Recommended Reading
Screening for Osteoporosis
The risk of suffering from osteoporotic fractures is 30-50% in women and 15 to 30% in men. ......
Osteoporosis
Osteoporosis is a bone disease that leads to an increased risk of fractures. The bone mass is ......
Discogram / Discography
Discogram is a diagnostic procedure in which x-ray dye or contrast material is injected into the ......
Spinal Cord Injury
Spinal cord injury is an injury to the spinal cord that results in temporary or permanent changes .....
Back Pain at Workplace: Prevention and Exercises
Understanding the basics about our back and our posture is very important in preventing back pain an...
Colle’s Fracture
Colles fracture or broken wrist is a wrist fracture, which occurs within an inch of the wrist joint....
Fracture
A fracture is a condition where the continuity of the bone is lost. Majority of bone fractures occur...
Kyphosis
Kyphosis is a spinal disorder, which is derived from Greek word – 'kyphos' which means bowed or ben...
Lifestyle And Osteoporosis
Encyclopedia section of medindia briefly explains about Lifestyle and Osteoporosis...
Rickets
Encyclopedia section of medindia explains in brief about Rickets...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use