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Concerned about spinal fracture surgery

Started by addcolts on 01/15/2010 4:23pm

My mom was recently diagnosed with a spinal fracture from osteoporosis. Our orthopedist is recommending vertebroplasty, but I read online that it doesnt work. Does anybody know anything about this?

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Consider the following:
Two studies published in The New England Journal of Medicine found no benefit to vertebroplasty:
• In a multicenter, randomized, double-blind, placebo-controlled trial involving 131 participants who were patients with one or two painful osteoporotic vertebral fractures, vertebroplasty did not result in greater improvement than a sham procedure in overall pain, physical functioning, or quality of life at 3 or 6 months after treatment.[2] Jeffrey Jarvik of the University of Washington said his study, funded by the National Institutes of Health, found vertebroplasty had no detectable benefit when compared with procedures that only mimicked such procedures. He advises that "vertebroplasty should not be done any longer, unless it's in the setting of a study.
• In a randomized trial involving 78 participants with osteoporotic vertebral compression fractures, patients who underwent vertebroplasty had improvements in pain and disability measures that were similar to those in patients who underwent a sham procedure.[3] University of Virginia radiologist Avery Evans said his study, which was funded by the Australian government and Cook Medical Inc., found vertebroplasty and sham procedures offered patients nearly identical pain relief.

I have a T9 compression fracture and have decided to do physical therapy and wait for at least 3 months before even thinking about surgery. I am in pain most of the time but it is managable. There are risk in any surgery and when something goes wrong in vertebroplasty (ie cement leakage) it can be very serious.

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This is what I find irritating.....doctors publish a report in a medical journal that something doesn't work (in this case vertebroplasty) and yet when I asked my doctor about it he said it was a lousy study, and nearly all doctors still do th eprocedure because they say lots of other studies does shows it works. So where does that leave us patients? Confused!!

My doctor said he does something called kyphoplasty, instead of kyphoplasty, and that this works better. Any thouhgts / advice anyone?

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It is a difficult topic since there are obviously very different outcomes with the same fracture type. Unfortunately, a lot of studies are somewhat biased, and financially driven. For osteoporotic compression fracture, kyphoplasty may be a better choice than vertebroplasty, because it does restore some vertebral body height. The relief is 60-70% at best and this is with good patient selection. It is another option for patients with severe fracture pain, but in no way that it is a guarantee fix. Sometimes a good body brace would help relieving some of the discomfort.

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