The prestigious Cochrane Review concluded it has no beneficial effect, and may even cause harm Vertebroplasty, which involves injecting cement into a fractured vertebra to mend and strengthen it, was first performed by French surgeons in 1984. In this first case, the fracture was caused by the growth of a tumour, and most vertebroplasty ops were used in this situation. However, in the US, the procedure came to be used more to help with the pain caused by spinal fractures, and that practice soon spread worldwide. Now, before you get too excited, it’s not seen as a panacea for chronic lower back pain. It’s restricted to people whose spinal fractures haven’t healed and who continue to have severe pain. Even so, vertebroplasty has been criticised. The prestigious Cochrane Review concluded it has no beneficial effect, and may even cause harm. A second report said vertebroplasty is no more effective for pain relief than local anaesthetic injections and can’t improve quality of life or disability. While this new evidence raises questions about the treatment, the procedure is still recommended by NICE. So where does that leave you? According to Sarah Leyland, osteoporosis nurse consultant at the National Osteoporosis Society, vertebroplasty isn’t a “routine procedure” and is only carried out in a few specialist centres in the UK. “Initially, you would need to discuss vertebroplasty with your doctor, who can refer you, if appropriate. Specialists differ in their views on the use of these procedures. Some feel that they are effective, others that the benefits are still unproven and that fractures generally get better on their own.” Dr Nicola Peel, a consultant in Sheffield, says many clinicians still believe it’s worthwhile to consider vertebroplasty, but only in a specific group of patients. “Some GPs may consider vertebroplasty in patients with severe pain that can be shown to be associated with an unhealed vertebral fracture and which hasn’t been adequately controlled using standard approaches to pain management. While it may not alter longer-term outcomes, it may enable more rapid rehabilitation, particularly pertinent when symptoms have led to hospital admission.” For Alison Doyle, the National Osteoporosis Society’s head of clinical practice, the new studies don’t necessarily mean vertebroplasty will no longer be offered to patients who really need it, if it’s possible for them to receive the treatment in their area. “I have seen patients who have been through this procedure and it has transformed their lives, yet the evidence in favour isn’t 100% convincing. I think this is very much a case of waiting to see what happens in terms of new evidence and announcements from NICE.” Not everyone can wait that long. Source
