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My doctor has given me two separate options for the treatment of a compression fracture in my spine. I can have antiinflammatories, a back brace, and some exercises. Eventually, the back will heal and I'll be all right. Or I could have day surgery to put some cement in there to hold it together while it heals. This time next year the end-results will be the same. But the cement treatment could get me back on my feet faster. Is it worth the money?
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Experts have asked the same question: these procedures provide rapid pain relief, but is the final outcome of treatment any different or better than standard medical care? Can the cost of these procedures be justified?
A review of the studies done in this area show that in the short-term (within the first two weeks to three months) patients experience significant improvement in pain, mobility, and quality of life with a vertebroplasty (the procedure you described). No wonder because they could stand up, sleep, sit, get dressed, go shopping, take a bath and participate in their usual activities once again. But when compared with standard medical care, the results weren't any different in the long-run (two years later).
Looking at the comparisons a little closer, there were some other benefits of vertebroplasty. Patients could use less pain medication, their general health improved in the first three months, and there were very few complications with the treatment. Patients with tumor-related compression fractures did not respond as well as patients with osteoporosis or trauma-induced fractures.
Vertebral compression fractures are painful enough that many people in the studies crossed over from standard medical care to the surgical procedure despite being assigned to the standard care group as part of the study. Seeing immediate pain relief and greater improvement in physical functioning in other patients after only 24 hours was the reason some patients insisted on crossing over.
Given those results, telling patients that standard care will have the same results as VP or KP in 12 to 24 months loses some of its punch. Although the evidence isn't always consistently high-level, the results of this systematic review support the use of vertebroplasty. Rapid pain relief, earlier mobilization, fewer and shorter hospitalizations all add up to improved care at a reduced cost.
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