Task force questions effectiveness of 2 spinal fusion procedures


The American Society for Bone and Mineral Research assembled a task force to study the relative efficacy and safety of the most commonly used procedures to treat osteoporotic spinal fractures: vertebroplasty and balloon kyphoplasty.

Results were published in the Journal of Bone and Mineral Research.

As the most comprehensive report to date, the research comes amid aggressive and sometimes misleading marketing for various vertebroplasty and balloon kyphoplasty marketing. "The message for [physicians] and their patients suffering from painful spinal fractures is that procedures to stabilize spinal fractures should not be a first choice for treatment," said task force member Peter Ebeling, MD.

Dr. Ebeling and other task force members concluded vertebroplasty provides no significant benefit in pain control over placebo or sham procedures. Additionally, due to the lack of placebo-controlled trials of balloon kyphoplasty the task force argues against the procedure.

The conclusions were based on the results of 300,000 patients who underwent vertebral augmentation procedures between 2006 and 2014. Over the time period, 73 percent of those patients underwent balloon kyphoplasty.

"The report makes it clear that these procedures are not a magic bullet," said Bart Clarke, MD, president of the American Society for Bone and Mineral Health. "Until now, [physicians] have been left to sift through the data on their own to determine whether these procedures can benefit their patients. This report coalesces all that information concisely and provides recommendations to guide them."

The task force issued the following guidance for healthcare professionals and their patients for managing spine fractures:

• Fully inform their patients of the available evidence: there is little to no evidence that the use of vertebral augmentation works any better than a placebo.

• Anti-osteoporosis medications should be started or continued. A change in treatment may also need to be considered if the fracture occurred after 12 months from starting anti-osteoporosis treatment.

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