Based on a lack of scientific evidence supporting the efficacy of vertebroplasty for the treatment of spinal compression fractures, the American Academy of Orthopaedic Surgeons is strongly recommending against the popular procedure, which involves injecting bone cement into the spinal vertebrae.

"When you look at the science and research to-date, there is very strong Level 1 evidence to suggest that vertebroplasty does not provide the types of benefits it was previously thought to provide," says Stephen I. Esses, MD, the Houston, Texas-based orthopedic surgeon who led the AAOS workgroup that developed a new clinical practice guideline on the treatment of symptomatic osteoporotic spinal compression fractures. In a press release, AAOS clarified that Level 1 evidence "refers to studies done under the strictest scientific guidelines, including blinding randomization."

The work group, which began researching this issue in 2008, largely based its recommendation on 2 randomized, controlled clinical trials published in the New England Journal of Medicine last year, which showed no statistical difference in back pain levels among patients who underwent vertebroplasty and the control group. The work group did not find published criticisms of the 2 trials to be scientifically compelling.

"Previous studies have touted the benefits of vertebroplasty, however our scientific research suggests this surgical procedure does not offer any advantages, over the placebo control," says Dr. Esses. He notes, however, that patients who have already undergone the procedure don't need to worry: "There are no reported negative side effects."

"To download the full guidelines, recommendations and information on work group members, click here.

Irene Tsikitas

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