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New guideline finds no evidence for a popular back procedure
Date:9/27/2010

Rosemont, Ill. As a patient safety best practice and endorsement of evidence-based medicine, the American Academy of Orthopaedic Surgeons (AAOS) Board of Directors approved and released a clinical practice guideline, which found a strong recommendation against a popular procedure called vertebroplasty as a way to treat fractures in the spine. Clinical practice guidelines are one avenue the Academy uses to ensure that patients receive high quality care.

  • Vertebroplasty is a surgical procedure developed to reduce or eliminate the pain associated with compression fractures of the spinal vertebrae. This procedure involves injecting bone cement into the vertebra to stabilize fractures.
  • A vertebroplasty patient is typically female, older than the age of 65, and shows signs of osteoporosis.

Orthopaedic surgeon Stephen I. Esses, MD, who practices in Houston, Texas, and chair of the workgroup that developed this guideline said the group reached their conclusion after methodically reviewing the literature, over a process of several years.

"It's very important to understand that we went into this without any preconceived notions or preferences, and we all agreed that the practice of medicine has to be based on science, and not anecdotal information," Dr. Esses stated. "When you look at the science and research to-date, there is very strong Level 1 evidence to suggest that vertebroplasty does not provide the types of benefits that it was previously thought to provide."

Level 1 evidence refers to studies done under the strictest scientific guidelines, including blinding randomization.

The recommendation against this procedure is largely based on two randomized, controlled clinical trials that were published in the New England Journal of Medicine (NEJM). According to the work group report, the studies compared vertebroplasty and a sham procedure and report "no statistically significant difference between t
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Contact: Lauren Pearson
pearson@aaos.org
847-384-4031
American Academy of Orthopaedic Surgeons
Source:Eurekalert

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