Navigation Links
Study Offers Support for Surgery After Compression Fracture
Date:8/10/2010

By Steven Reinberg
HealthDay Reporter

TUESDAY, Aug. 10 (HealthDay News) -- After studies last year found that a type of surgery called vertebroplasty was no better than a sham procedure in treating painful compression fractures, a new study now suggests the therapy can, in fact, ease some patients' pain.

In this (typically) outpatient procedure, doctors inject a type of stabilizing cement into the affected part of the spine.

For some people with weak bones who fracture the small bones in their spine -- an injury called an acute osteoporotic vertebral compression fracture -- vertebroplasty can be a safe and effective treatment, Dutch researchers conclude in the Aug. 10 online edition of The Lancet.

The study was funded in part by Cook Medical, which makes material used in vertebroplasty.

"Pain relief after the procedure is immediate, sustained for one year, and is significantly better than that achieved with conservative treatment and at acceptable costs," wrote a team led by Dr. Caroline Klazen, from St. Elisabeth Ziekenhuis in Tilburg, the Netherlands.

But other experts cast doubt on the findings, noting that for most of the study participants, pain resolved on its own without the need for surgery.

The new Dutch study involved 431 patients, aged 50 or older, with osteoporotic vertebral compression fractures. The patients had been in pain for six weeks or less. The researchers randomly assigned them to receive vertebroplasty or conservative treatment.

Conservative treatment included taking pain relievers, ice and heat treatments, and later a stretching and back strengthen program. In addition, a back brace may be called for, experts say.

However, the researchers noted that more than half (53 percent) of participants had their pain spontaneously disappear during the assessment phase of the study.

Among the 202 remaining patients, the 101 treated with vertebroplasty had greater pain relief after a month and a year, compared with those who underwent conservative treatment, Klazen's group found.

But even among those who did not get vertebroplasty, 60 percent achieved pain relief, leaving only 41 whose pain continued without therapy.

There were no serious side effects or complications from vertebroplasty, the researchers stated.

One important drawback to the study was that patients and doctors knew who received which therapy, Klazen's team noted. That could have affected patient responses and the radiologists' assessments, they noted.

Not everyone was convinced by the study findings.

The fact that many people saw their pain clear up on their own, without the surgical intervention, "confirms that we have been managing patients appropriately for all these years -- by waiting six weeks [before treatment]," said Dr. David F. Kallmes a professor of radiology at the Mayo Clinic. He was not involved in the study.

Kallmes helped conduct one of the studies published in 2009 in the New England Journal of Medicine that found the surgery was no better than a "sham" procedure in treating compression fracture pain.

Kallmes noted that of the 431 patients selected for the study, more than 50 percent improved without treatment. "And among the 100 who didn't get treated [with vertebroplasty], 60 percent of those achieved relief at one month. That means that almost 90 percent of the 330 patients who didn't receive cement achieved a good outcome without cement," he said.

If those patients who would not improve without treatment could be identified, that "would be great," Kallmes said. "But we still are unable to" spot those patients, he added, so it's difficult to predict which patients would gain from the surgical technique.

Compared to standard therapy, cost could become a factor, as well. Although the researchers call vertebroplasty's price tag "acceptable," total costs can run about $5,000 including the cost of an MRI scan, Kallmes said.

Another expert, Dr. Eugene J. Carragee, a professor of orthopedic surgery and chief of the spine surgery center at Stanford University, is also not a fan of vertebroplasty for most patients.

"None of the controlled trials, including this one, have even remotely confirmed the 80 to 90 percent rate of complete and immediate pain relief described in original reports of this procedure," he noted.

In fact, about 60 to 70 percent of the effect seen in the vertebroplasty group was also seen in the control group, Carragee said. "This strongly suggests that most of the improvement in the vertebroplasty group was not due to the procedure alone," he pointed out.

"The vertebroplasty treatment effect probably includes some direct effect and some placebo effect. But it is unlikely that all of the apparent treatment effect is placebo," Carragee added.

More information

For more information on compression fractures of the back, visit the U.S. National Library of Medicine.

SOURCES: David F. Kallmes M.D., professor, radiology, Mayo Clinic, Rochester, Minn.; Eugene J. Carragee, M.D., professor, orthopedic surgery, and chief, spine surgery center, Stanford University, Stanford, Calif.; Aug. 10, 2010, The Lancet, online


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. More Medicaid Patients Using ERs, Study Finds
2. Study shows physicians reluctant to use chemoprevention for prostate cancer
3. Many Stroke Patients Stop Taking Meds, Study Shows
4. UC Denver study finds beautiful women face discrimination in certain jobs
5. Surgery better than radiation, hormone treatments for some prostate cancer, study shows
6. Tattooing linked to higher risk of hepatitis C: UBC study
7. Women Can Safely Get Pregnant Right After Miscarriage, Study Shows
8. Type 2 Diabetes Might Harm Young Brain, Study Suggests
9. Study shows splitting bowel preparation dosage is most effective cleansing method before colonoscopy
10. Epilepsy Drugs Dont Raise Suicide Risk, Study Shows
11. Study finds proximity could be key to success of healing prayer
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Study Offers Support for Surgery After Compression Fracture
(Date:6/26/2016)... ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer is helping ... fitness app. The fitness app plans to fix the two major problems leading the fitness ... size fits all type program , They don’t eliminate all the reasons people ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... "With 30 ... their specific project," said Christina Austin - CEO of Pixel Film Studios. , ... and all within Final Cut Pro X . Simply select a ProHand generator ...
(Date:6/25/2016)... ... ... Conventional wisdom preaches the benefits of moderation, whether it’s a matter of indulgence ... high can result in disappointment, perhaps even self-loathing. However, those who set the bar ... from PsychTests.com reveals that behind the tendency to set low expectations is ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... Conference and Scientific Sessions in Dallas that it will receive two significant new ... the grants came as PHA marked its 25th anniversary by recognizing patients, medical ...
(Date:6/24/2016)... ... , ... People across the U.S. are sharpening their pencils and honing their ... in which patients and their families pay tribute to a genetic counselor by nominating ... of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. , In April, ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 Roche ... received 510(k) clearance for its Elecsys BRAHMS PCT (procalcitonin) ... severe sepsis or septic shock. With this clearance, Roche ... provide a fully integrated solution for sepsis risk assessment ... associated with bacterial infection and PCT levels in blood ...
(Date:6/23/2016)... VIEW, Calif. , June 23, 2016 ... a.m. CST on Thursday, July 7, 2016 , , , ... kayla.belcher@frost.com ) , , , , EXPERT PANELISTS:  , ... Nitin Naik; Senior Industry Analyst, Christi Bird; Senior Industry Analyst, Divyaa ... The global pharmaceutical industry is witnessing an ...
(Date:6/23/2016)... 23, 2016 The vast majority of dialysis ... facility.  Treatments are usually 3 times a week, with ... including travel time, equipment preparation and wait time.  This ... grueling for patients who are elderly and frail.  Many ... and rehabilitation centers for some duration of time. ...
Breaking Medicine Technology: