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Spinal Approaches Linked to Similar Pain Outcomes

Study compared percutaneous vertebroplasty, conservative treatment in osteoporotic fractures

WEDNESDAY, June 16 (HealthDay News) -- In older patients with osteoporotic vertebral fractures, conservative treatment may be associated with similar improvements in pain as percutaneous vertebroplasty, according to research published in the June 1 issue of Spine.

Rikke Rousing, M.D., of the University Hospital of Odense in Denmark, and colleagues analyzed data from 49 patients (mean age of 80 years) with acute or subacute osteoporotic fractures. Patients were randomized to receive either percutaneous vertebroplasty using bone cement or conservative treatment.

The researchers found that patients receiving percutaneous vertebroplasty showed reduced pain 12 to 24 hours after the procedure. However, at three-month follow-up, the groups showed similar levels of pain reduction as assessed by a visual analog scale. The groups also didn't vary significantly in terms of changes on the physical and mental components of the Short Form-36, most aspects of the Dallas Pain Questionnaire, and several other assessments. The authors further note that at three months the percutaneous vertebroplasty group had a higher risk of new fractures (relative risk, 2.9).

"In summary, we consider percutaneous vertebroplasty as a good treatment for some patients with acute or subacute painful osteoporotic compression fractures in the spine, but the majority of patients will recover after a few months of conservative treatment. In particular, percutaneous vertebroplasty is suitable for patients at increased risk with the conservative treatment, e.g., patients with chronic obstructive lung disease, where pain relief with opioids would be contraindicated," Rousing and colleagues conclude.

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