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

d 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 ru
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