Is a Common Medical Procedure Unnecessary?

Sister Rogene Fox, 81, was suffering from severe back pain until she agreed to a popular treatment, reports CBS News medical correspondent Dr. Jon LaPook. She believed it worked.

"I just thought, thank God. I don't care what I received," Fox said. "I feel good! I don't have pain!"

But it turns out she got relief without getting the procedure, called Vertebroplasty, a common treatment for patients with painful back fractures from osteoporosis.

Wednesday, two separate studies in the New England Journal of Medicine report there was no difference up to six months later for patients who actually had the procedure and those who had a fake or placebo treatment instead.

"I thought, 'Wow, we're onto something,'" said Dr. David Kallmes, a study author. "We saw many placebo patients get full pain relief. I have no idea why."

During Vertebroplasty, doctors inject medical cement into fractured bone in the back to strengthen the area and reduce pain. The placebo was just a shot to temporarily numb the area. Vertebroplasty is endorsed by multiple medical societies, but the surprising findings may force doctors to rethink the treatment.

"I was quite amazed," said Dr. Kenneth Chapman, a pain management specialist. "Vertebroplasty is one of the most rewarding procedures I do, and to take that and say that it doesn't work, to me, I have a hard time digesting that."

It's a money maker for specialists. In recent years, the number of these procedures has doubled to at least 40,000 annually, each one costing $2,000 to $5,000.

"Patients must be empowered to make decisions based on best evidence," said Dr. James Weinstein, the chair of orthopaedic surgery at Dartmouth-Hitchcock Medical Center in New Hampshire.

These results point to the kind of savings President Obama has said can be achieved, when there are well-designed studies on whether expensive treatments really work.

"I think that what we know is that right now there's a whole lot of care that's not improving health," Mr. Obama said in a July interview. "And our main focus is on how we can stop putting money into things that aren't making people healthy."

"These two studies I think represent great examples of the kind of work the President is looking for," Dr. Weinstein said.

But it remains to be seen whether physicians will change their behavior based on this new evidence.

"Everybody says they want evidence-based medicine," Dr. Kallmes said. "Sometimes the evidence is not what you asked for."

It's one thing for patients and doctors to believe a treatment works, it's another to know the facts. That's why Congress has earmarked $1 billion to study the effectiveness of many different treatments.
  • Jonathan M.D.

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