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Vertebroplasty is not a do-not-do treatment

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Vertebroplasty has been controversial but remains clinically useful and new evidence awaits publication

Duckett and colleagues have classified vertebroplasty as a do-not-do treatment.1 They referenced two randomised controlled trials (RCTs)2,3 as definitive proof of this. However, the authors failed to heed our clinical opinion published in the MJA that these two trials were “not relevant to the patient group that we treat with vertebroplasty”.4 We have the largest clinical vertebroplasty experience in Australia, yet our published advice was apparently ignored. In the article by Duckett and colleagues, Box 1 illustrated the selection process that the authors used to determine do-not-do procedures. The process supposedly excluded evidence which was “contested” or “which was not supported by consulted clinical experts”. Accordingly, vertebroplasty should have been deleted from the list.

The authors used the United Kingdom National Institute for Health and Care Excellence (NICE) for clinical guidance. Current NICE guidance5 states that “vertebroplasty and kyphoplasty can be considered appropriate interventions for people with recent, unhealed osteoporotic vertebral compression fractures in whom…