Correspondence (letter to the editor): Disappointing

I read the article by Mpotsaris et al with interest, hoping to gain an understanding of the effectiveness of the increasingly widely used percutaneous vertebroplasty (1). Table 1, showing the patients’ pre-interventional status, seemed informative and well structured. But what followed was a disappointment and unsatisfactory from a clinical as well as a scientific perspective. The result tables show only P values. Not a single symptom was quantified or qualified according to the original table. Since no control group with conservative treatment had been evaluated in the study, readers do not learn whether any advantage exists for the intervention. In many patients receiving conservative treatment for osteoporosis and vertebral fractures, at least pain and mobility improve within one to three months. A current study with a comparison group showed exactly the same P values for symptom improvement in both therapeutic arms (2).

Instead, the discussion dismantles the “negative” results of two high ranking, published, prospective randomized studies by using questionable arguments (3, 4); both studies had at least attempted to make a genuine comparison by means of elaborate sham procedures. In terms of the popularity, reputation, and visibility of Deutsches Ärzteblatt International, I would have wished for a more objective and understandable presentation of the topic. Maybe a critical editorial would have been helpful, too.