An analysis of the medical literature has found vertebroplasty may provide more pain relief and better function than nonoperative treatments for patients with osteoporotic vertebral compression fractures, according to a study published in Clinical Orthopaedics and Related Research.
Researchers at Zhejiang University in China, led by Ming-Min Shi, found vertebroplasty can have similar or additional benefits over other treatments, despite conflicting results to date.
In the study, the researchers used meta-analysis to compare percutaneous vertebroplasty (PVP) with nonoperative therapy and sham injections in the treatment of vertebral compression fractures. Pain, function and vertebral fracture recurrence were all considered.
The team searched PubMed, EMBASE, Medline and the Cochrane library for relevant articles, using 9 of the 469 they found (number of patients: 886). They then used a random effects model to evaluate pain reduction at different times as a primary outcome, with quality of life (QOL) used as a pain-related disability measure.
“We used subgroup analysis to reinvestigate pain relief and function improvement of PVP based on two different controls: nonoperative therapy and sham injection,” the authors wrote. Nonoperative treatment was considered bed rest, pain relief and bracing.
According to a press release, when compared with nonoperative therapy PVP was more effective at relieving pain and improving QOL in patients with vertebral fractures — however, pain relief and QOL were comparable between PVP and sham injection groups at various time points. All groups had similar risks for recurring fractures.
“Different control groups in individual studies to date may explain the varying conclusions about the ability of vertebroplasty to relieve pain and improve patients’ quality of life,” the authors wrote. “Indeed, some studies compare PVP to sham injections, others to nonoperative therapy. Our analysis shows that, compared with other treatments, PVP relieves pain and improves quality of life as well as, or better, without increasing the risk of new fractures.”
Shi MM, Xun-Zi C, Lin T, et al. Is there really no benefit of vertebroplasty for osteoporotic vertebral fractures? A meta-analysis. Clin Orthop Relat Res. 2012. doi: 10.1007/s11999-012-2404-6