Case series have shown that anesthetic or steroid injections alone can reduce vertebral fracture pain, which may explain the improvement in pain scores in both the real and sham-surgery groups in the vertebroplasty trials, he suggested.
There also may be a difference between the two surgeries that produce different results from kyphoplasty or vertebroplasty. Randomized, controlled trials comparing the two are underway.
Further research is needed on optimal patient selection, on whether the surgeries prevent kyphosis, and on long-term outcomes, Dr. Bauer said.
The 700,000 vertebral compression fractures in the United States each year hospitalize more than 150,000 people.
Dr. Bauer has received research funding from Amgen and Novartis.
Clinicians should consider kyphoplasty before resorting to vertebroplasty for an osteoporotic fracture (above).
Source Courtesy Dr. Victor Jaramillo/Dr. Aravind Pothineni