Talk:Vertebral augmentation

Vertebral augmentation article needs major revision
Dear Wikipedia

The vertebral augmentation page continues to cite the 2018 Cochrane review of vertebroplasty as core evidence that vertebroplasty is ineffective.

We published a methodologically sound criticism of the Cochrane review, which has not been challenged by Cochrane authors (DOI: 10.1136/bmjebm-2019-111171). It is not an opinion - it is methodologically sound description of several fundamental breaches of Cochrane protocol. The Australian Medicare Services Advisory Committee has recommended resumption of Medicare funding in Australia for thoraco-lumbar fractures less than or equal to 3-weeks duration despite the lead author of the Cochrane review being on the MSAC committee. Meta-analysis of vertebroplasty published by Lou et al in 2019 concluded that vertebroplasty was safe and effective for patients with fractures less than 6-weeks duration with severe, unremitting pain  (Osteoporos Int. 2019 Dec;30(12):2369-2380. doi: 10.1007/s00198-019-05101-8.) Evidence review by Lamanna et al in 2019 in its conclusion writes "All RCTs evaluating vertebroplasty exclusively in patients with acute VCFs found it to be superior to conservative treatment or placebo, including a high‐quality sham‐controlled RCT. Despite recent Cochrane reviews, it may be that vertebroplasty has clinical value in treating acute VCFs, particularly in patients with severe pain.") (Lamanna A et al. Vertebroplasty for acute painful osteoporotic vertebral compression fractures: An update. First published: 20 May 2019 https://doi.org/10.1111/1754-9485.12900)

I have included four groups of authors (Clark et al, Lou et al, Lamanna et al and the 20 members of the Australian Medicare Services Advisory Committee) who find vertebroplasty effective for the management of acute osteoporotic vertebral fractures causing severe pain versus one group in the Cochrane review who don't.

The Wikipedia page is misleading in its current version and misinforms patients. Please arrange to have it rewritten or removed.

Yours Sincerely

Dr William Clark Lead author VAPOUR trial (Lancet. 2016; http://dx.doi.org/10.1016/S0140-6736(16)31341-1) Investigator Kallmes trial (N Engl J Med 2009; 361:569-579 DOI: 10.1056/NEJMoa0900563) Author Diamond et al trial 2006 ( doi: 10.5694/j.1326-5377.2006.tb00148 ) Author Diamond et al 2020 (Diamond, T. et al. Early vertebroplasty within 3 weeks of fracture for acute painful vertebral osteoporotic fractures: subgroup analysis of the VAPOUR trial and review of the literature. Eur Spine J 29, 1606–1613 (2020). https://doi.org/10.1007/s00586-020-06362-2) Osteoporos Int. 2019 Dec;30(12):2369-2380. doi: 10.1007/s00198-019-05101-8 DOI: 10.1136/bmjebm-2019-111171 Williamxrayclark (talk) 02:03, 27 October 2020 (UTC)


 * These two newer meta-analyses you point to do appear to be reliable review articles, and it seems that this article's intro relies too much on the two negative reviews. Does anyone watching this page have any comments about how to present the results of these reviews? – Thjarkur (talk) 08:37, 27 October 2020 (UTC)