Evidence Lacking for Benefit of Surgery for Vertebral Fractures
MONDAY, Jan. 28, 2019 -- Surgical procedures do not appear to provide significant benefit for patients with vertebral fractures (VF), according to a second American Society for Bone and Mineral Research Task Force report published in the January issue of the Journal of Bone and Mineral Research.
Peter K. Ebeling, M.B.B.S., M.D., from Monash University in Melbourne, Australia, and colleagues examined the efficacy and safety of vertebral augmentation and other nonpharmacological approaches for the treatment of pain after VF.
The researchers found that percutaneous vertebroplasty provides no demonstrable clinically significant benefit over placebo for patients with acutely painful VF. There was no difference in the results based on pain duration. There was insufficient evidence to support kyphoplasty over nonsurgical management, percutaneous vertebroplasty, vertebral body stenting, or the Kiva system. Limited evidence was available for determining the risk for incident VF or serious adverse effects related to percutaneous vertebroplasty or kyphoplasty. Harms could not be excluded and no recommendations could be made about them. It is unclear whether spinal bracing improves physical function, disability, or quality of life for patients with painful VF. Mobility may be improved by exercise, which could also reduce pain and fear of falling, but does not reduce the risk for falls or fractures.
"While patients who had these surgeries may have had a short-term reduction in pain, we found that there was no significant benefit over the long-term in improving pain, back-related disability, and quality of life when compared with those who did not have the procedures," Ebeling said in a statement.
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Posted: January 2019