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The ability of NASA's Mars Reconnaissance Orbiter to continue charting the locations of these hidden glaciers and ice-filled valleys -- first confirmed by radar two years ago -- adds clues about how these deposits may have been left as remnants when regional ice sheets retreated. The subsurface ice deposits extend for hundreds of kilometers, or miles, in the rugged region called Deuteronilus Mensae, about halfway from the equator to the Martian north pole. Jeffrey Plaut of NASA's Jet Propulsion Laboratory, Pasadena, Calif., and colleagues prepared a map of the region's confirmed ice for presentation at this week's 41st Lunar and Planetary Science Conference near Houston. The Shallow Radar instrument on the orbiter has obtained more than 250 observations of the study area, which is about the size of California. "We have mapped the whole area with a high density of coverage," Plaut said. "These are not isolated features. In this area, the radar is detecting thick subsurface ice in many locations." The common locations are around the bases of mesas and scarps, and confined within valleys or craters. Plaut said, "The hypothesis is the whole area was covered with an ice sheet during a different climate period, and when the climate dried out, these deposits remained only where they had been covered by a layer of debris protecting the ice from the atmosphere."

The North American Spine Society and the Society of Interventional Radiology have pointed to flaws in both studies. And earlier studies, published over 15 years, found major benefits to kyphoplasty and a related procedure called vertebroplasty. "We're missing opportunities for patients to receive a safe and effective treatment that can significantly reduce their pain and disability," said Malamis, an interventional radiologist. The procedures are used to treat vertebral compression fractures in patients with osteoporosis and other conditions that result in brittle bones. In a vertebroplasty, an acrylic cement is injected into a fractured vertebra. In a kyphoplasty, a balloon-tipped catheter first is inserted into the fracture. The balloon is inflated to restore the height and shape of the vertebra before the cement is injected. Neva Nelson, 74, of Naperville, Ill., said a kyphoplasty that Malamis performed in October, 2009, has greatly reduced her pain in a vertebra in her lower back that she fractured after falling on ice. Before her kyphoplasty, Nelson had to sit on cushions. Walking, and especially standing, were painful. "I had to do something," she said. "I could not go on like that." Nelson said that since undergoing her kyphoplasty, "I don't have to worry about my back any more." In the controversial studies, patients were randomly assigned to receive a vertebroplasty or a placebo-like "sham" procedure. In the sham procedure, patients received an injection of anesthetic, but no cement. However, patients in severe pain are reluctant to enroll in a trial where there's a 50 percent chance of receiving a sham treatment. In one of the studies, researchers had to screen 1,813 patients to enroll just 131 subjects. In the other study, only 78 of 219 eligible patients were enrolled. This low enrollment rate raises the possibility that the patients who did enroll were not representative. Patients experience the greatest pain during the first three months after a compression fracture. Thereafter, pain gradually subsides. Thus, a vertebroplasty or kyphoplasty provides the greatest benefit when performed within a week or two of the fracture. But the studies enrolled patients up to 12 months after fractures. In addition to reducing pain and disability, a kyphoplasty can reduce the risk of subsequent fractures by improving the angle and height of the spine. The studies evaluated vertebroplasty alone, and did not include the more innovative and very different kyphoplasty procedure. Malamis suggests the medical community wait for the results of additional studies now underway before passing final judgment on vertebroplasty or kyphoplasty. In the mean time, he notes that Medicare still covers the procedures.