Comparison of analgesic therapies in traumatic vertebral compression fractures: Vertebroplasty and kyphoplasty versus thermal facet ablation-a prospective randomized trial
In brief
Facet ablation matched fracture pain relief with no complications in 245 patients
In a single-center randomized trial, radiofrequency facet ablation and vertebral augmentation reduced pain by about 5 points on a 10-point scale at six months. No complications were reported among 245 ablation patients, who were discharged the same day; augmentation caused cement leakage in 8% of patients. The results support ablation as an alternative, but broader safety evidence is still needed.
- Journal
- North American Spine Society journal (Q1)
- Published
- 2 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Tamás Tóth, Kerim Watfa, Márton Balázsfi, Pál Barzó
- PMID
- 42992005
- DOI
- 10.1016/j.xnsj.2026.100954
Why clinicians should know about it
- Picked for Orthopedics and Sports Medicine (paper of the day, 7 November 2026): Randomized comparison of treatments for painful vertebral compression fractures
- Picked for Spine Surgery (paper of the day, 7 November 2026): RCT comparing vertebral augmentation vs facet ablation
Abstract
BACKGROUND: Vertebral augmentation techniques are common for painful vertebral compression fractures (VCFs). Radiofrequency thermal facet ablation (RFA) is a potential alternative analgesic therapy, but comparative data remains limited. METHODS: In this single-center, prospective randomized controlled trial, patients with painful VCFs refractory to conservative treatment were randomized to vertebral augmentation or RFA. Pre- and postoperative Visual Analogue Scale (VAS) for axial pain and procedure-related complications were evaluated over a 6-month period. RESULTS: Among 535 patients completing follow-up (290 augmentation, 245 RFA), both arms provided robust analgesia. Mean VAS reduction at 6 months was -5.3 (95% CI: -5.6 to -5.0) in the RFA group and -5.6 (95% CI: -5.9 to -5.3) in the augmentation group. The augmentation group had an 8% cement leakage rate (23 cases), with 2 patients (0.5%) requiring decompression, and a mean length of stay (LOS) of 1.4 days. The RFA arm demonstrated a zero-complication rate and allowed for same-day discharge (LOS 0.0 days). CONCLUSIONS: RFA and vertebral augmentation are highly effective at providing significant pain relief for VCFs, with comparable reductions in pain scores. With a zero-complication rate and outpatient feasibility, RFA is a safe and resource-efficient first-line alternative to cement-based augmentation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.