title: VERTOS II: percutaneous vertebroplasty versus conservative therapy in patients with painful osteoporotic vertebral compression fractures; rationale, objectives and design of a multicenter randomized controlled trial.
abstract: BACKGROUND
  The standard care in patients with a painful osteoporotic vertebral compression fracture (VCF) is conservative therapy. Percutaneous vertebroplasty (PV), a minimally invasive technique, is gaining popularity as a new treatment option. Many prospective and retrospective studies have reported on the effectiveness and safety of PV, but no large randomized controlled trial (RCT) has been published.
  
  
  OBJECTIVE
  To estimate cost-effectiveness of PV compared to conservative therapy in terms of: pain reduction, quality of life, complications, secondary fractures and mortality.
  
  
  METHODS
  The VERTOS II study is designed as a prospective, multicenter RCT. Patients with a painful VCF with bone edema on MR imaging, local back pain for 6 weeks or less, osteopenia and aged 50 years or older, after obtaining informed consent are included and randomized for PV or conservative therapy. In total 200 patients will be enrolled. Follow-up is at regular intervals during a 1-year period with standard questionnaires, addressing: clinical symptoms, pain medication, Visual Analogue Scale (VAS) score, quality of life and cost-effectiveness. Secondary fractures, necessary additional therapies and complications are recorded.
  
  
  CONCLUSIONS
  The VERTOS II study is the first methodologically sound RCT designed to assess the cost-effectiveness of PV compared to conservative therapy in patients with an acute osteoporotic VCF.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov, NCT00232466.
authors.affiliation: Department of Radiology, St, Elisabeth Hospital Tilburg, The Netherlands. cahklazen@hotmail.com
authors.forename: C A H
authors.initials: CA
authors.lastname: Klazen
authors.forename: H J J
authors.initials: HJ
authors.lastname: Verhaar
authors.forename: L E H
authors.initials: LE
authors.lastname: Lampmann
authors.forename: J R
authors.initials: JR
authors.lastname: Juttmann
authors.forename: M C
authors.initials: MC
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authors.initials: FH
authors.lastname: Jansen
authors.forename: A V
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authors.lastname: Tielbeek
authors.forename: M C
authors.initials: MC
authors.lastname: Schoemaker
authors.forename: E
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authors.lastname: Buskens
authors.forename: Y
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authors.lastname: van der Graaf
authors.forename: X
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authors.lastname: Janssens
authors.forename: H
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authors.lastname: Fransen
authors.forename: K J
authors.initials: KJ
authors.lastname: van Everdingen
authors.forename: A F
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authors.lastname: Muller
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authors.lastname: Mali
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authors.initials: PN
authors.lastname: Lohle