Greater functional improvement seen after vertebroplasty vs conservative treatment
AMSTERDAM — A recently presented meta-analysis of six randomized controlled trials including about 800 patients showed pain scores at early follow-up favored vertebroplasty over nonoperative care for patients with osteoporotic vertebral compression fractures.
Paul A. Anderson, MD, of Madison, Wisc., and colleagues designed the meta-analysis to serve as an unbiased systematic review of results.
For primary outcomes defined in the studies, as well as key pain, disability and health-related quality of life scores, “three studies had no significant difference. Three studies were significantly in favor of vertebroplasty, and so the overall results favored vertebroplasty,” Anderson said during his presentation here.
Vertebroplasty had a “fairly large effect size” of about 0.73 for reduced pain at 3 follow-up or earlier, Anderson said. Late time points, he said, were defined in the study as postoperative results at greater than 3 months through 26 weeks.
“Indeed, there was a statistical difference in that the early time points favored a better outcome. Although both time points were statistically in favor of vertebroplasty, the results were more significant at the early time point than late,” Anderson said.
Concerning functional outcomes, “the overall effect size was positive in favor of vertebroplasty. Health-related quality of life [was] in favor of vertebroplasty,” according to Anderson.
Anderson and colleagues also conducted a regression analysis to study refractures, but found no statistical difference for the rates between the treatment groups.
“In selective patients, cement augmentation offers greater pain relief, functional improvements, quality of life than conservative management and we did not see any evidence of new fractures,” Anderson said, noting the formal statistical analysis also revealed no publication biases.
Anderson PA, Froyshteter AB, Tontz W. Meta-analysis of vertebroplasty compared to conservative treatment. Paper #171. Presented at SpineWeek 2012. May 28-June 1. Amsterdam.
Disclosure: Anderson receives royalties from Stryker, Pioneer, is a consultant to Aesculap and Pioneer and owns stock in Pioneer, Titan, Expanding Orthopedics and SI Bone.