Spinal Fracture: Cement No Better Than Sham
Studies Raise Questions About Popular Treatment for Osteoporosis-Related Spinal Compression Fractures
More Patients Needed for Trials
For this reason, Kallmes says he will not recommend the cement injections to patients in the future unless they agree to participate in clinical trials.
Interventional radiologist Avery Evans, MD, tells WebMD that there has been so much hype about the cement injections, patients have been reluctant to enroll in trials if it meant they might not get the treatment.
An associate professor of radiology and neurosurgery at the University of Virginia, Evans agrees that more research is needed to determine if vertebroplasty benefits specific subgroups of patients.
“Up until now no one was willing to randomize their patients because they were so convinced that vertebroplasty was the greatest thing in the world,” he says. “Now it’s time for us to admit that we aren’t as smart as we thought we were and ask the questions, ‘Are there patients who are helped by this treatment, and who are they?'"
In an editorial published with the studies, James N. Weinstein, DO, who directs the Dartmouth Institute for Health Policy and Clinical Practice, questioned whether the sham treatment really was a placebo treatment and whether either treatment was better than no treatment at all.
He pointed out that of the approximately 750,000 people who suffer from vertebral fractures each year, only about a third receive any kind of treatment.
“Although (the two trials) provide the best available scientific evidence for an informed choice, it remains to be seen whether there will be a paradigm shift in the treatment of vertebral compression fractures with vertebroplasty or similar procedures,” he writes.