Letter to the Editor: Is There Really No Benefit of Vertebroplasty for Osteoporotic Vertebral Fractures? A Meta-analysis
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To the Editor
We read with interest the article by Shi et al.  published in your journal that addresses the controversial topic of percutaneous vertebroplasty (PVP) using meta-analysis of selected literature. The authors’ conclusion  appears to contradict Recommendation 8 of the American Academy of Orthopaedic Surgeons (AAOS) “Clinical Practice Guideline (CPG) on the Treatment of Symptomatic Osteoporotic Spinal Compression Fractures” . We would like to address the differences between their analysis and that done by the AAOS CPG Workgroup.
Although the meta-analysis process was similar in both reviews, some methodologic aspects differ. AAOS established a priori content based inclusion and exclusion criteria for study selection . It is unclear how Shi et al. determined which articles to include. The AAOS Workgroup excluded three studies that they included [1, 4, 8] for poor study design description and for not being the best available evidence. A study is not the best available ...
- Alvarez L, Alcaraz M, Perez-Higueras A, Granizo JJ, de Miguel I, Rossi RE, Quinones D. Percutaneous vertebroplasty: functional improvement in patients with osteoporotic compression fractures. Spine (Phila Pa 1976). 2006;31:1113–1118.
- American Academy of Orthopaedic Surgeons: Clinical Practice Guideline on the Treatment of Symptomatic Osteoporotic Spinal Compression Fractures. Rosemont, IL, American Academy of Orthopaedic Surgeons, September 2010. Available at: http://www.aaos.org/research/guidelines/SCFguideline.asp. Accessed September 7, 2012.
- Buchbinder, R, Osborne, RH, Ebeling, PR, Wark, JD, Mitchell, P, Wriedt, C, Graves, S, Staples, MP, Murphy, B (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 361: pp. 557-568 CrossRef
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- Farrokhi, MR, Alibai, E, Maghami, Z (2011) Randomized controlled trial of percutaneous vertebroplasty versus optimal medical management for the relief of pain and disability in acute osteoporotic vertebral compression fractures. J Neurosurg Spine. 14: pp. 561-569
- Kallmes, DF, Comstock, BA, Heagerty, PJ, Turner, JA, Wilson, DJ, Diamond, TH, Edwards, R, Gray, LA, Stout, L, Owen, S, Hollingworth, W, Ghdoke, B, Annesley-Williams, DJ, Ralston, SH, Jarvik, JG (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 361: pp. 569-579 CrossRef
- Klazen, CA, Lohle, PN, Vries, J, Jansen, FH, Tielbeek, AV, Blonk, MC, Venmans, A, Rooij, WJ, Schoemaker, MC, Juttmann, JR, Lo, TH, Verhaar, HJ, Graaf, Y, Everdingen, KJ, Muller, AF, Elgersma, OE, Halkema, DR, Fransen, H, Janssens, X, Buskens, E, Mali, WP (2010) Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial. Lancet. 376: pp. 1085-1092 CrossRef
- Rousing R, Andersen MO, Jespersen SM, Thomsen K, Lauritsen J. Percutaneous vertebroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-months follow-up in a clinical randomized study. Spine (Phila Pa 1976). 2009;34:1349–1354.
- Shi MM, Cai XZ, Lin T, Wang W, Yan SG. Is there really no benefit of vertbroplasty for osteoporotic vertebral fractures? A meta-analysis. Clin Orthop Relat Res. 2012 June 23. [Epub ahead of print]
- Voormolen, MH, Rooij, WJ, Sluzewski, M, Graaf, Y, Lampmann, LE, Lohle, PN, Juttmann, JR (2006) Pain response in the first trimester after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures with or without bone marrow edema. AJNR Am J Neuroradiol. 27: pp. 1579-1585
- Wang, HK, Lu, K, Liang, CL, Weng, HC, Wang, KW, Tsai, YD, Hsieh, CH, Liliang, PC (2010) Comparing clinical outcomes following percutaneous vertebroplasty with conservative therapy for acute osteoporotic vertebral compression fractures. Pain Med. 11: pp. 1659-1665 CrossRef
- Letter to the Editor: Is There Really No Benefit of Vertebroplasty for Osteoporotic Vertebral Fractures? A Meta-analysis
Clinical Orthopaedics and Related Research®
Volume 471, Issue 2 , pp 686-687
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