Society of Interventional Radiology Supports Vertebroplasty in Properly Selected Patients

In spite of recent reports that showed vertebroplasty was as effective as placebo, the Society of Interventional Radiology has come out in support of the procedure as an effective procedure for properly selected patients, as the society says was not the case in the studies, according to an SIR news release.

"Hundreds of thousands of patients have greatly benefited from vertebroplasty with almost complete resolution of their pain; tens of thousands dependent on intravenous narcotics have been discharged from the hospital virtually pain- and drug-free following their treatment," SIR President Brian F. Stainken, MD, FSIR, said in the release. "Candidates for the procedure are those who have failed to respond to conventional medical treatment (such as rest, analgesics and narcotic drugs). Vertebroplasty can give patients their lives back. Interventional radiologists have the critical skills in imaging and patient care that make them experts at determining which patients are the most appropriate candidates to receive the treatment."

The two studies in debate were published in August in the New England Journal of Medicine and showed that patients received similar results when injected with medical bone-grade cement (vertebroplasty) or a placebo. Criticism of the studies include small numbers of patients treated; the small percentage of eligible patients who were actually enrolled in the trial; inclusion of patients with milder degrees of pain and disability than are usually treated in a typical practice; the small amount of cement injected; treatment of patients with chronic compression fractures; the incomplete use of MRI or CT to confirm that the fracture was the likely source of pain; and the high rate of crossover from placebo to vertebroplasty in one of the studies, according to the release.

SIR worries that the decisions based on possibly flawed findings could lead to insurers to deny coverage of the procedures in osteoporosis patients who could benefit from it, according to the release. Results from additional studies on the procedure are scheduled to be released at SIR's annual meeting in March.

Read the SIR's report on patient selection in vertebroplasty (pdf).