Comment on Vertebroplasty 9 18 09

    North American Spine Society Newly Released Vertebroplasty RCTs: A Tale of Two Trials Summary On August 6, 2009, the New England Journal of Medicine published two randomized controlled trials on vertebroplasty: A Randomized Trial of Vertebroplasty for Painful Osteoporotic Vertebral Fractures [1] and A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures [2] . As the only multidisciplinary organization representing spine care providers, the North American Spine Society (NASS) has reviewed the studies and crafted the following comments on these important new studies and their significance to patient care. A common initial reaction to the findings of these two prospective randomized controlled trials (PRCTs) has been surprise and even disbelief. A prominent, respected academician-surgeon who is an internationally respected leader in the field of osteoporosis research had described the procedure as “an opportunity to do something really good for patients [3].” Numerous large case series, both prospective and retrospective, had demonstrated very encouraging results with dramatic pain relief in appropriately selected patients. Even higher level data derived from a prospective comparative cohort study indicated a clear benefit over nonoperative treatment [4]. Moreover, for any physician who has performed vertebral augmentation procedures for osteoporotic compression fractures, experience has indicated that patients have dramatic ...