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Society of Interventional Radiology Supports Treatment for Painful Spine Fractures: Patient Selection Key
Date:1/19/2010

wn for vertebroplasty and possibly kyphoplasty because of the controversy generated by the two NEJM studies," said Stainken. If that occurs, access to these procedures would be limited to patients enrolled in approved trials, leaving many patients in severe pain without a solution. SIR is keeping a watchful eye on this to protect patients' access to medical treatment. SIR will continue to serve as a leader in future trials of vertebroplasty that may confirm or contradict these studies or may identify subsets of patients more likely to benefit from vertebral augmentation, noted the SIR president.

      SIR member and vertebroplasty expert J. Kevin McGraw, M.D., FSIR, agrees. "While we welcome the two studies by researchers David F. Kallmes, M.D., and Rachelle Buchbinder, Ph.D., to the body of literature on this technique, the results of these trials are discordant with personal experience and more than 15 years of accumulated medical literature espousing the benefits of vertebroplasty," said McGraw, section head, interventional radiology, at Riverside Radiology and Interventional Associates in Columbus, Ohio. "SIR recognizes the value of randomized controlled trials and evidence-based medicine; however, the weakness in the studies and the degree of discordance between the outcomes of these studies, prior studies and experience, suggest that it is premature—and possibly incorrect—to conclude that vertebroplasty is no better than a control sham procedure," he noted.

      Criticisms of both studies include the small numbers of patients treated; the small percentage of eligible patients who were actually enrolled in the trial; inclusion of patients with milder degrees of pain and disability than are usually treated in a typical practice; the small amount of cement injected; tre
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