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	<title>Before You Take That Pill &#187; bisphosphonates</title>
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		<title>Vertebroplasty Found to be Useless for Osteoporotic Fracture and Disk Pain</title>
		<link>http://www.beforeyoutakethatpill.com/index.php/2009/08/06/vertebroplasty-found-to-be-useless-for-osteoporotic-fracture-and-disk-pain/</link>
		<comments>http://www.beforeyoutakethatpill.com/index.php/2009/08/06/vertebroplasty-found-to-be-useless-for-osteoporotic-fracture-and-disk-pain/#comments</comments>
		<pubDate>Thu, 06 Aug 2009 14:05:29 +0000</pubDate>
		<dc:creator>Doug Bremner</dc:creator>
				<category><![CDATA[Osteoporosis]]></category>
		<category><![CDATA[bisphosphonates]]></category>
		<category><![CDATA[osteopenia]]></category>
		<category><![CDATA[vertebroplasty]]></category>

		<guid isPermaLink="false">http://www.beforeyoutakethatpill.com/?p=3873</guid>
		<description><![CDATA[Two articles in today's New England Journal of Medicine are the first randomized placebo controlled trials of vertebroplasty, a procedure which involves injecting cement into the vertebrae of people who have suffered from painful osteoporotic fractures of the vertebrae. In the first study 78 patients got either vertebroplasty or a fake procedure. There was no difference in pain ratings measured at several time points out to six months. ]]></description>
			<content:encoded><![CDATA[<p>Two articles in today&#8217;s <em>New England Journal of Medicine</em> are the first randomized placebo controlled trials of vertebroplasty, a procedure which involves injecting cement into the vertebrae of people who have suffered from painful osteoporotic fractures of the vertebrae. In the <a href="http://content.nejm.org/cgi/content/short/361/6/557">first study</a> 78 patients got either vertebroplasty or a fake procedure. There was no difference in pain ratings measured at several time points out to six months.</p>
<p><a rel="attachment wp-att-3874" href="http://www.beforeyoutakethatpill.com/index.php/2009/08/06/vertebroplasty-found-to-be-useless-for-osteoporotic-fracture-and-disk-pain/vertebroplasty/"><img class="alignnone size-full wp-image-3874" title="vertebroplasty" src="http://www.beforeyoutakethatpill.com/wp-content/uploads/2009/08/vertebroplasty.gif" alt="vertebroplasty" width="800" height="451" /></a></p>
<p>The <a href="http://content.nejm.org/cgi/content/short/361/6/569?query=nextarrow">second study</a> involved 131 patients who got either a sham or vertebroplasty procedure. There were no differences in the primary outcomes of pain or disability at one month after treatment. There was a pattern of clinical improvement in pain (30% reduction in pain, 64% v 48%, p=0.06) that was not one of the original study outcomes. The group that got the sham procedure, however, were more likely to request a repeat procedure (i.e. got a vertebroplasty in the end) (43% v 12%, p&lt;.05). Some of the authors said they were &#8220;shocked&#8221; by the results and others said they should do &#8220;more research&#8221; or that it &#8220;might help some patients&#8221; or &#8220;maybe they want a placebo&#8221; since the fake group got better as well as the vertebroplasty group. Maybe they should pay the $4,000 for the MRI and procedure out of their pockets rather than billing it to Medicare so that they have a better placebo response. That would help out on <a href="http://content.nejm.org/cgi/content/short/361/6/569?query=nextarrow">President Barack Obama&#8217;s plans to reduce US healthcare costs</a> by eliminating the 30% of tests and procedures that have been found to be useless. He can add this one to the list.</p>
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