Commentary on: Staples MP, Kallmes DF, Comstock BA, et al.. Effectiveness of vertebroplasty using individual patient data from two randomised placebo controlled trials: meta-analysis. BMJ 2011;343:d3952.
Context
Osteoporotic vertebral compression fractures (VCF) are a significant public health concern worldwide. Percutaneous vertebral augmentation or vertebroplasty was introduced to alleviate the pain and reduce the disability associated with VCF in patients failing conservative therapy, but were at very high-risk for open surgery. Due to the apparent success and low morbidity of vertebroplasty, these indications were expanded and widespread use ensued until several randomised trials evaluated the efficacy of vertebroplasty in VCF.1–5 Of these, two double-blind sham-controlled randomised trials (ie, the INVEST and Australian trials) demonstrated that vertebroplasty is no more effective than sham surgery.1 3 This finding contradicts the existing prolific observational literature, and caused...
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