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| |  Vertebroplasty Relieves Pain Better Than Conservative Treatment in Acute Vertebral Fractures: Presented at SIR By Thomas R. Collins TAMPA, Fla -- March 15, 2010 -- Vertebroplasty led to significant pain relief compared with conservative therapy for patients with acute vertebral compression fractures, according to results from a study presented here at the 35th Annual Scientific Meeting of the Society of Interventional Radiology (SIR). At every time point -- from day 1 to 1 year -- in the 202-patient study, results on the Visual Analogue Scale for pain were significantly better among patients who received vertebroplasty than those on conservative treatment. On March 14, Caroline Klazen, MD, University Medical Center, Utrecht, the Netherlands, presented the results of the multicentre, randomised, controlled Percutaneous Vertebroplasty Versus Conservative Therapy in Patients With an Acute Osteoporotic Vertebral Compression Fracture (VERTOS-II) trial. The results come after 2 recent studies published in the New England Journal of Medicine called into question whether vertebroplasty actually relieves pain in osteoporotic patients with vertebral fractures. In those studies pain scores were similar for vertebroplasty patients and patients in a sham procedure group. But Dr. Klazen noted that the patient groups were small in those studies and that bone oedema was not an inclusion criterion. “This may explain the very limited gain of VAS scores of only 2 or 3 points in this study after vertebroplasty, so it still remains unclear for the clinician what the best treatment option is,” she said. In the VERTOS-II study, patients with back pain for <=6 weeks, bone oedema found on a magnetic resonance imaging of the fracture, focal tenderness on the vertebral compression fracture level, and decreased bone density with T scores of <=-1 were randomised to percutaneous vertebroplasty or conservative therapy. At baseline, there was no difference between the groups, both of which included 101 patients. The average VAS score was 7.5. Pain scores were better among patients in the vertebroplasty group at day 1 (VAS 3.7 vs 6.7; P < .001); at 1 week (3.5 vs 5.6; P < .001); at 1 month (2.5 vs 4.9; P < .001); at 3 months (2.5 vs 3.9; P = .025); at 6 months (2.3 vs 3.9; P = .014); and at 1 year (2.2 vs 3.8; P = .014). “After vertebroplasty, you can see an immediate and steep decrease in VAS scores, continuing over time,” said Dr. Klazen. “After conservative therapy there’s a much slower decrease in VAS scores. And very important, at all moments in time the difference between both groups is significant, even after 12 months.” “Vertebroplasty provides significantly better pain relief during 1 year follow-up,” she said. [Presentation title: Percutaneous Vertebroplasty Versus Conservative Therapy in Patients With an Acute Osteoporotic Vertebral Compression Fracture. Vertos II: A Randomized Controlled Trial. Abstract 11]
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