Editorials

Vertebroplasty for osteoporotic vertebral fracture

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.a178 (Published 05 June 2008) Cite this as: BMJ 2008;336:1261
  1. Robert G W Lambert, associate professor and chair,
  2. Kamran Golmohammadi, clinical research fellow
  1. 1Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada T6G 2B7
  1. robert.lambert{at}capitalhealth.ca

    Consensus on the indications is needed to avoid indiscriminate use

    The first percutaneous injection of bone cement into the spine was performed in 1984 to treat a 54 year old woman with extreme pain caused by a haemangioma in the second cervical vertebra. Surprisingly, pain relief was complete.1 After the case was published, indications for percutaneous vertebroplasty quickly expanded to include treatment of chronic back pain caused by metastases and osteoporotic fracture.

    Since then, many case series have indicated that vertebroplasty is an effective way to control the pain of vertebral compression fracture caused by osteoporosis. The immediate relief of pain is often dramatic and, especially for the chronically debilitated patient, it may seem miraculous. The results are fairly consistent, and in one large case series of 552 patients, improvement in pain and disability persisted throughout two years of follow-up.2 Unfortunately, in the only published randomised controlled trial of vertebroplasty, almost all patients in the control group—who received conservative care—crossed over to the intervention group two weeks after randomisation, so the results were difficult to interpret.3 …

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