The AAOS has only included studies published before Dec 2009 - which is curious given the publication of VERTOS11 earlier this year. The VERTOS11 study is clearly the largest RCT of vertebroplasty yet published. It studied acute fractures less than 6 weeks old and found vertebroplasty effective on several fronts. Vertebroplasty provided significant pain reduction at every time point out to 12 months. It also prevented ongoing fracturing and height loss in the vertebral body.
The placebo armed trials which the AAOS relies so heavily upon, studied healed fractures up to 12 months old. Despite the statistical algorithm a trial can be no more than what it samples. The current evidence shows that vertebroplasty is not effective for chronic, healed fractures but is very effective for acute fractures. I should have thought this would be self-evident to orthopaedic surgeons. I presume that the AAOS does not recommend other fracture fixation techniques (eg plaster cast) to palliate acute fracture pain to fractures that are 6 months old.
The position of the AAOS is 10 months out of date and scientifically meaningless.
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The AAOS has only included studies published before Dec 2009 - which is curious given the publication of VERTOS11 earlier this year. The VERTOS11 study is clearly the largest RCT of vertebroplasty yet published. It studied acute fractures less than 6 weeks old and found vertebroplasty effective on several fronts. Vertebroplasty provided significant pain reduction at every time point out to 12 months. It also prevented ongoing fracturing and height loss in the vertebral body.
October 11, 2010 - 5:04amThe placebo armed trials which the AAOS relies so heavily upon, studied healed fractures up to 12 months old. Despite the statistical algorithm a trial can be no more than what it samples. The current evidence shows that vertebroplasty is not effective for chronic, healed fractures but is very effective for acute fractures. I should have thought this would be self-evident to orthopaedic surgeons. I presume that the AAOS does not recommend other fracture fixation techniques (eg plaster cast) to palliate acute fracture pain to fractures that are 6 months old.
The position of the AAOS is 10 months out of date and scientifically meaningless.
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