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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 2010; 192 (3): 174-175.

In reply: The letters by Graziotti and Pile raise spurious issues that in no way threaten the key message of our trials.

Rachelle Buchbinder, NHMRC Practitioner Fellow, Director,1 and Professor2
Richard H Osborne, NHMRC Population Health Fellow, Chair of Public Health and Director3
David Kallmes, Professor of Radiology4
1 Monash Department of Clinical Epidemiology at Cabrini Hospital, Cabrini Hospital and Monash University, Melbourne, VIC.
2 Department of Epidemiology 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.
Article References: 
Reference Text: 
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.
Reference Order: 
1
PubMed ID: 
17353335
Reference Text: 
Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 2009; 373: 1016-1024.
Reference Order: 
2
PubMed ID: 
19246088
Reference Text: 
Kallmes DF, Comstock BA, Gray LA, et al. Baseline pain and disability in the Investigational Vertebroplasty Efficacy and Safety Trial. AJNR Am J Neuroradiol 2009; 30: 1203-1205.
Reference Order: 
3
PubMed ID: 
19246522
Reference Text: 
Kaufmann TJ, Trout AT, Kallmes DF. The effects of cement volume on clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol 2006; 27: 1933-1937.
Reference Order: 
4
PubMed ID: 
17032870
Reference Text: 
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.
Reference Order: 
5
PubMed ID: 
19478654

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