Vertebroplasty not worthwhile for patients with osteoporosis?

For patients with recent osteoporotic vertebral fractures, there is no significant benefit of vertebroplasty compared with a sham procedure. Only modest improvement was seen over time in patients who underwent both procedures in overall scores for pain and scores for pain at rest and during the night, physical functioning, and quality of life.

In a multicenter, randomized, double-blind, placebo-controlled trial, Buchbinder and associates randomly assigned 78 patients with painful, unhealed osteoporotic vertebral fractures to undergo vertebroplasty or a sham procedure. Outcomes were assessed at regular intervals for 6 months afterward; the primary outcome was overall pain.

There were no significant differences between the groups at any of the follow-up visits, regardless of the patient’s sex or the duration of symptoms. Both groups reported a significant reduction in overall pain at 3 months. Physical functioning, quality of life, and perceived improvement all improved, and use of opioid analgesics decreased. Seven patients-3 from the surgical group and 4 from the sham group-sustained a clinical vertebral fracture within 6 months after their procedure.

The authors noted that their findings call into question the use of vertebroplasty for patients with recent osteoporotic vertebral fractures.