To the Editor: Clinical trials study a restricted patient group, so their results may not be generalisable to a different population subgroup or the population as a whole. The editorial by Buchbinder, Osborne and Kallmes1 about their recent vertebroplasty studies2,3 concludes that vertebroplasty offers no benefit over placebo. They suggest that, in light of their trials, the decision to list vertebroplasty on the Medical Benefits Schedule will be reviewed later this year. I understood the review to have been part of the original listing on the benefits schedule and not as a result of their studies, and I suggest that their editorial generalises results to a subpopulation of early acute vertebral fractures that they did not study.
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- University of Western Sydney, Sydney, NSW.
- 1. Buchbinder R, Osborne RH, Kallmes D. Vertebroplasty appears no better than placebo for painful osteoporotic spinal fractures, and has potential to cause harm [editorial]. Med J Aust 2009; 191: 476-477. <MJA full text>
- 2. Buchbinder R, Osborne R, Ebeling P, et al. A randomised trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 2009; 361: 557-568.
- 3. Kallmes DF, Comstock BA, Heagerty PJ, et al. A randomised trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 2009; 361: 569-579.
- 4. 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.