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Vertebroplasty appears no better than placebo for painful osteoporotic spinal fractures, and has potential to cause harm

Rachelle Buchbinder, Richard H Osborne and David Kallmes
Med J Aust 2009; 191 (9) || doi: 10.5694/j.1326-5377.2009.tb02906.x
Published online: 2 November 2009

Two randomised placebo-controlled trials show the importance of establishing the efficacy of procedures before adopting them into clinical practice

Vertebral fractures are a common manifestation of osteoporosis, and up to half such fractures result in severe pain and disability. Although most heal within weeks or a few months, some people experience persisting discomfort. Best supportive care includes bed rest, analgesia and physical therapy, and some patients require hospitalisation.

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  • 1 Monash Department of Clinical Epidemiology, Cabrini Hospital, Melbourne, VIC.
  • 2 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC.
  • 3 Public Health Innovation, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University, Melbourne, VIC.
  • 4 Mayo Clinic, Rochester, Minn, USA.



  • 1. Buchbinder R, Osborne RH. Vertebroplasty: a promising but as yet unproven intervention for painful osteoporotic spinal fractures [editorial]. Med J Aust 2006; 185: 351-352. <MJA full text>
  • 2. Medical Services Advisory Committee. Minutes 31st meeting — 24 August 2005 — Brisbane. http://www.msac.gov.au/internet/msac/publishing.nsf/Content/minutes-1 (accessed Sep 2009).
  • 3. Hollingworth W, Jarvik JG. Evidence on the effectiveness and cost-effectiveness of vertebroplasty: a review of policy makers’ responses. Acad Radiol 2006; 13: 550-555.
  • 4. Medicare Australia. Medicare item reports (search for items 35400, 35402). https://www.medicareaustralia.gov.au/statistics/mbs_item.shtml (accessed Sep 2009).
  • 5. Gray D, Hollingworth W, Onwudiwe N. Costs and state-specific rates of thoracic and lumbar vertebroplasty, 2001–2005. Spine 2008; 33: 1905-1912.
  • 6. Buchbinder R, Osborne R, Ebeling P, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009; 361: 557-568.
  • 7. Kallmes D, Comstock B, Heagerty P, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 2009; 361: 569-579.
  • 8. Voormolen M, Mali W, Lohle P, et al. Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS Study. AJNR Am J Neuroradiol 2007; 28: 555-560.
  • 9. Rousing R, Andersen M, Jespersen S, et al. Percutaneous vertebroplasty compared with conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months follow-up in a clinical randomized study. Spine 2009; 34: 1349-1354.
  • 10. Haynes R, Sackett D, Guyatt G, Tugwell P. Clinical epidemiology: how to do clinical practice research. 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2006.

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