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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2008.306asm-4-306LettersVertebroplasty in osteoporosis-related vertebral fractures Sadat-Ali Mir King Faisal University, College of Medicine, Orthopaedic Surgery, PO Box 40071 Al-Khobar, Alkhobar Eastern 31952, Saudi Arabia, T: +966505848281, F: +96638971013, drsadat@hotmail.comJul-Aug 2008 28 4 306 306 Copyright © 2008, Annals of Saudi Medicine2008This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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To the Editor: I read with great interest the brief report by Dr. Nizar Al-Nakshabandi entitled “Percutaneous vertebroplasty in patients with osteoporotic vertebral body fractures.”1 Certain issues need to stand corrected. The author’s assertion that “there are no well established pain management protocols” is untrue. If this is the indication for vertebroplasty then it is incorrect to do the procedure. The author has failed to mention anywhere in the article the indications for vertebroplasty in general and the indications in their patients. It is important to make clear that the prime indication of vertebroplasty is failure of conservative treatment of osteoporosis2 or vertebral fractures refractory to medical therapy.3

Osteoporosis particularly in postmenopausal women is a growing problem in Saudi Arabia and it appears it will grow further with the aging of population.4,5 The author discussed the study of El-Desouki et al6 which appeared to be out of context as it does not indicate any prevalence of osteoporosis related vertebral fractures. The reported prevalence of osteoporosis-related vertebral fractures in the Saudi society was 18.2% and none of these patients were treated by vertebroplasty.7

It is unfortunate that the author failed to mention in the conclusion that vertebroplasty is not a procedure to be taken lightly and has its own complications and needs to be done at regional centers where such procedures are done on a regular basis.
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REFERENCES
1 Al-Nakshabandi N   Percutaneous vertebroplasty in patients with osteoporotic vertebral body Fractures Annals of Saudi Med 2008 28 2 120 3 
2 Gill JB  Kuper M  Chin PC  Zhang Y  Schutt R   Comparing pain reduction following kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures Pain Physician 2007 10 583 590 17660858 
3 Hendrikse CA  Kalmijn S  Voormolen MH  Verhaar HJ  Mali WP   Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression Fractures: review of the literature Ned Tijdschr Geneeskd 2003 147 32 1553 9 12942846 
4 Bubshait D  Sadat-Ali M   Economic Implications of Osteoporosis Related Femoral Fractures In the Saudi Arabian Society Calcif Tissue Int 2007 12 81 6 455 8 18066484 
5 Sadat-Ali M  AlElq AM   Male Osteoporosis Among Saudi Arabian Population: A pilot study Annals of Saudi Med 2006 26 6 450 54 
6 El-Desouki M   Osteoporosis in postmenopausal women using dual x-ray bone densitometry Saudi Med J 2003 24 9 953 6 12973476 
7 Sadat-Ali M  Gullenpet AH  Al-Mulhim F  Al-Turki HA  Al-Shammary H  Al-Elq AM  Al-Othman A   Osteoporosis related vertebral fractures: its prevalence in Saudi Arabian society Osteoporosis Int 2007 18 Suppl 1 S102 3