North American Spine Society responds to findings of recent vertebroplasty studies

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The North American Spine Society (NASS) today released comments on two recent studies on vertebroplasty and their significance to patient care.

NASS’ comments, posted in the online edition of The Spine Journal, were issued in response to two randomized controlled trials on vertebroplasty for osteoporotic spine fractures, published Aug. 6 in The New England Journal of Medicine. Both studies examined the benefit of vertebroplasty when compared to sham procedures.

“Evidence and experience related to use of vertebroplasty have been overwhelmingly positive prior to the publication of the studies by Buchbinder et al, and Kallmes et al. Spine care providers are now faced with a large chasm between the previous data and experiences and these latest studies,” Christopher M. Bono, MD, orthopedic surgeon at Brigham & Women's Hospital in Boston, said in a press release.

“The data from these two new studies must be considered carefully and thoughtfully. The findings are not surprising or dissimilar from previous data; however, the conclusions drawn by the authors may not be as decisive as they appear,” said Bono, who is also an executive board member and the Evidence-based Guideline Development Committee Chair for NASS.

“Practical conclusions should be made based on a thorough and systematic review of all the literature in order to better define the subgroup of patients for which vertebroplasty might be most appropriate,” he said in the press release.

According to the NASS statement, the association’s primary concerns were about the studies’ patient selection, including issues related to fracture acuity, patient enrollment, control group management and outcomes.

“Both groups of authors should be congratulated for undertaking the difficult task of performing high-level studies on an important clinical disorder in our aging population,” Bono said in the press release. “The intent of this analysis is not to in any way defame the studies or question the integrity of the authors. Instead, it is to perhaps help explore why there is such a seeming disconnect between the conclusions of these two prospective randomized controlled trials and the previous experience and data.”