Editorials

No more vetebroplasty for acute vertebral compression fractures?

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1756 (Published 09 May 2018) Cite this as: BMJ 2018;361:k1756
  1. Evan Davies, consultant spinal surgeon
  1. Spinal Surgery Unit, Southampton General Hospital, University Hospital Southampton Trust, Southampton SO16 6YD, UK
  1. evan.davies{at}uhs.nhs.uk

Fresh evidence shows no benefit for fractures under 9 weeks old

Vertebral compression fractures associated with osteoporosis can cause acute pain. Long term, these fractures can lead to deformity, respiratory problems, and loss of height.1 The increased kyphosis causes problems with mobilisation, eating, sitting, sleeping, and looking forward.

Previous studies have reported conflicting results on the effectiveness of treating acute osteoporotic compression fractures with percutaneous injections of bone cement.2 Vertebroplasty—the injection of acrylic bone cement into fractured vertebrae—was first performed in France in 1984. Initially designed to treat painful tumour deposits, vertebroplasty for osteoporotic compression fractures became more widespread in the United States in the 1990s. Its use expanded throughout the world. Since then, vertebroplasty has been at the centre of a longstanding controversy about benefits, risks, and cost effectiveness.3

In a linked article, Firanescu and colleagues (doi:10.1136/bmj.k1551) report a well constructed randomised trial of 180 older adults with 1-3 painful vertebral compression fractures of …

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