Abstract
Introduction A promising new approach in the treatment of osteoporosis is the reinforcement of fractured vertebrae with percutaneous injection of bone cement: percutaneous vertebroplasty. This paper reviews the current state of medical literature on this topic and raises concerns about the rapid acceptance of this procedure despite the poor quality of the evidence relating to its safety and efficacy.
Methods We performed a search and critical formal review of the available literature on percutaneous vertebroplasty listed in the MEDLINE database.
Results We found it difficult to summarize the distinct cases reported in the literature because of duplication of case reports and questionable citation in summary reports. Pain relief within 48 hours of treatment was almost universally reported, although clearly defined outcome measures and long-term follow-up were often not reported. The most common complication was leakage of the cement, with 90 instances reported out of 226 patients treated. The leaks were associated with clinical symptoms in three percent of the instances.
Conclusions New high-tech solutions to difficult medical problems are enticing. We must force new treatments through rigorous assessments before proclaiming them safe and successful. The percutaneous vertebroplasty literature fails in this responsibility.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
