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Surgery to repair spinal fractures no better for pain relief than injections, study finds

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Spinal surgery in older patients with osteoporosis is no more effective for pain relief than injections, according to a study published by The BMJ.

A randomised trial of 180 older adults with painful vertebral compression fractures of up to nine weeks’ duration showed that vertebroplasty (surgery to repair spinal fractures) is no better for pain relief than local anaesthetic injections into the same area.

The surgical intervention had no effect on quality of life or on disability during the 12-month follow-up period.

The study did not include an untreated control group, so both treatments are potentially better than nothing for pain relief. However, if that is the case, local anaesthetic injections are likely to be cheaper, safer and equally beneficial.

According to The BMJ, the authors suggest that there is still a place for vertebroplasty “when efficacy outweighs the risks,” but they conclude that their findings “do not support using percutaneous vertebroplasty as standard pain treatment in patients with acute osteoporotic vertebral compression fractures.”

The trial suggests that vertebroplasty “should not be offered to patients with three or fewer painful osteoporotic vertebral fractures of less than 6-9 weeks’ duration,” said Evan Davies, consultant spinal surgeon at Southampton General Hospital, in a linked editorial.

Davies goes on to note that questions remain over use of the procedure in managing chronic painful fractures, and whether cement augmentation has any role in the prevention of long term morbidity and mortality.

He concludes that early vertebroplasty — before nine weeks — “should probably be considered only in exceptional circumstances for patients with vertebral osteoporotic fractures.”

If you’re suffering from osteoporotic vertebral compression fractures, a consultation with an experienced spine specialist at Wimbledon Clinics will help determine the best treatment option for you.