Electical Stimulation
We are unable to recommend for or against electrical stimulation for patients who present with an osteoporotic spinal compression fracture on imaging with correlating clinical signs and symptoms and who are neurologically intact.
Rationale
One Level I study addressed the use of electrical stimulation limited to symptomatic patients with chronic vertebral compression fractures, with short term follow up of three months.69 This study had insufficient power to find a difference in this treatment when compared to a control group for the critical outcome measure of pain relief as well as quality of life. A surrogate outcome measure of change in use of NSAIDs was reported but the change in use was based on percentage of patients using less NSAIDs with electrical stimulation as opposed to the actual amount of NSAIDs used by individual patients. This outcome measure has little clinical significance and no quantitative measure to gauge pre vs. post treatment effect. Because of the inability to detect a difference in pain (an outcome that is critical to understand treatment effectiveness) or quality of life ,the evidence is inconclusive and we are unable to recommend for or against this treatment.