Cement your spine to ease your pain

A study has found that patients report less back pain at rest and while active following vertebroplasty.

A new study published in the American Journal of Neuroradiology has found that patients report less back pain at rest and while active following vertebroplasty, a procedure in which medical cement is injected into painful compression  fractures  in  the spinal  vertebrae  due  to osteoporosis. Patients also reported improved function in their daily activities, such as walking, housework and getting dressed.

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"These findings give us as good evidence as there is in a study without a group receiving another or no treatment for comparison that patients are more functional for up to a year after vertebroplasty than before vertebroplasty," said David Kallmes, the Mayo Clinic neuroradiologist who led the study.

The investigators conducted the study to assess vertebroplasty with a well-validated questionnaire specifically designed to measure back pain, the Roland-Morris Disability Questionnaire (RDQ). They reviewed records of 113 Mayo Clinic vertebroplasty patients. Of this group, RDQ scores were available for 108 patients before vertebroplasty treatment, and after treatment for 93 patients at one week, 73 patients at one month, 46 patients at six months and 15 patients at one year.

Patients' pain during rest and activity improved an average of seven points one week after treatment and remained improved one year following vertebroplasty. Prior to treatment, the average RDQ score was 18 on a scale of 23. The RDQ dropped to an average score of 11 immediately after treatment and remained at that level throughout the study.

Dr. Kallmes explains that in light of the wide practice of vertebroplasty for vertebral compression fractures, a study using a top-caliber back pain measurement tool like the RDQ was critical, especially in light of the often subjective nature of pain reporting by different patients.

"It's hard to remember your pain. Also, it's hard to say how bad my pain is compared to your pain. I've had patients say their pain is no better after treatment, yet I look at them and they look 10 times better," he said.

Dr. Kallmes explains that ultimately, vertebroplasty  needs evaluation through a study of the highest quality, a clinical trial in which patients are randomly assigned to  receive treatment or no treatment and in which the patients  and investigators are blinded to which patients receive the real treatment or a placebo used for comparison.