Current Management Principles of Osteoporosis Spine Fractures

Authors

  • I Ketut Suyasa pine Division, Department of Orthopaedic & Traumatology, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia
  • Febyan Resident of Orthopaedic & Traumatology, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia
  • Agus Satrya Wibawa I Made Department of Orthopaedic & Traumatology, Prof Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia

DOI:

https://doi.org/10.31282/joti.v5n3.107

Keywords:

Osteoporosis, Degenerative, Spine, Fracture, Management

Abstract

Osteoporosis is a serious issue. Osteopenia and osteoporosis are conditions brought on by the slow decrease of bone mass with age. Osteoporosis has been divided into major and secondary categories. Loss of skeletal mass and an imbalance between bone resorption and remodeling are the causes of osteoporosis. Fracture risk assessment is important and useful in predicting future fracture risk. Neurological indications and symptoms may occur when the fracture irritates the nerve root, necessitating open surgical operations like decompression or stabilization. The morbidity, mortality, and expenditure linked to osteoporotic fractures, as well as the availability of efficient pharmacological drugs for management, underscore the need of detecting and treating "high-risk" persons. However, the existing healthcare system is inadequate, and several individuals who are at a high risk of developing an osteoporotic fracture are neither detected nor given treatment. Treatment options for osteoporotic include both nonsurgical and surgical therapies.

Downloads

Download data is not yet available.

References

Blattert, T. R., Schnake, K. J., Gonschorek, O., Gercek, E., Hartmann, F., Katscher, S., Mörk, S., Morrison, R., Müller, M., Partenheimer, A., Piltz, S., Scherer, M. A., Ullrich, B. W., Verheyden, A., & Zimmermann, V. (2018). Nonsurgical and Surgical Management of Osteoporotic Vertebral Body Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Global Spine Journal, 8(2 Suppl), 50S. https://doi.org/10.1177/2192568217745823

Bridgeforth, G. M., & Nolden, M. (2022). Chance Fractures. Lippincott’s Primary Care Musculoskeletal Radiology. https://doi.org/10.1007/978-3-319-31524-9_23

Chandra, R. v., Maingard, J., Asadi, H., Slater, L. A., Mazwi, T. L., Marcia, S., Barr, J., & Hirsch, J. A. (2018). Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data? American Journal of Neuroradiology, 39(5), 798–806. https://doi.org/10.3174/AJNR.A5458

Clark, W., Bird, P., Gonski, P., Diamond, T. H., Smerdely, P., McNeil, H. P., Schlaphoff, G., Bryant, C., Barnes, E., & Gebski, V. (2016). Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet (London, England), 388(10052), 1408–1416. https://doi.org/10.1016/S0140-6736(16)31341-1

Comprehensive Orthopaedic Review AAOS online access available. (n.d.).

Ferrari, S. L., & Roux, C. (n.d.). Pocket Reference to Osteoporosis.

Ganesan, K., Jandu, J. S., Anastasopoulou, C., Ahsun, S., & Roane, D. (2022). Secondary Osteoporosis. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK470166/

Garg, B., Dixit, V., Batra, S., Malhotra, R., & Sharan, A. (2017). Non-surgical management of acute osteoporotic vertebral compression fracture: A review. Journal of Clinical Orthopaedics and Trauma, 8(2), 131. https://doi.org/10.1016/J.JCOT.2017.02.001

Grossbach, A. J., Dahdaleh, N. S., Abel, T. J., Woods, G. D., Dlouhy, B. J., & Hitchon, P. W. (2013). Flexion-distraction injuries of the thoracolumbar spine: open fusion versus percutaneous pedicle screw fixation. Neurosurgical Focus, 35(2), E2. https://doi.org/10.3171/2013.6.FOCUS13176

Ji, M.-X., & Yu, Q. (2015). Primary osteoporosis in postmenopausal women. Chronic Diseases and Translational Medicine, 1(1), 9. https://doi.org/10.1016/J.CDTM.2015.02.006

Keen, M. U., & Reddivari, A. K. R. (2022). Osteoporosis In Females. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK559156/

Keupp, K., Beleggia, F., Kayserili, H., Barnes, A. M., Steiner, M., Semler, O., Fischer, B., Yigit, G., Janda, C. Y., Becker, J., Breer, S., Altunoglu, U., Grünhagen, J., Krawitz, P., Hecht, J., Schinke, T., Makareeva, E., Lausch, E., Cankaya, T., … Wollnik, B. (2013). Mutations in WNT1 Cause Different Forms of Bone Fragility. American Journal of Human Genetics, 92(4), 565. https://doi.org/10.1016/J.AJHG.2013.02.010

Kim, J. H., Park, Y.-S., Oh, K. J., & Choi, H. S. (2017). Surgical treatment of severe osteoporosis including new concept of advanced severe osteoporosis. Osteoporosis and Sarcopenia, 3(4), 164. https://doi.org/10.1016/J.AFOS.2017.11.006

Lehman, R. A., Kang, D. G., & Wagner, S. C. (2015). Management of osteoporosis in spine surgery. The Journal of the American Academy of Orthopaedic Surgeons, 23(4), 253–263. https://doi.org/10.5435/JAAOS-D-14-00042

Lewiecki, E. M. (2021a). Osteoporosis: Clinical Evaluation. Endotext. https://www.ncbi.nlm.nih.gov/books/NBK279049/

Lewiecki, E. M. (2021b). Osteoporosis: Clinical Evaluation. Endotext. https://www.ncbi.nlm.nih.gov/books/NBK279049/

Liu, J., Liu, Z., Luo, J., Gong, L., Cui, Y., Song, Q., Xiao, P. F., & Zhou, Y. (2019). Influence of vertebral bone mineral density on total dispersion volume of bone cement in vertebroplasty. Medicine, 98(12). https://doi.org/10.1097/MD.0000000000014941

Mirza, F., & Canalis, E. (2015). SECONDARY OSTEOPOROSIS: PATHOPHYSIOLOGY AND MANAGEMENT. European Journal of Endocrinology / European Federation of Endocrine Societies, 173(3), R131. https://doi.org/10.1530/EJE-15-0118

Parva, N. R., Tadepalli, S., Singh, P., Qian, A., Joshi, R., Kandala, H., Nookala, V. K., & Cheriyath, P. (2018). Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus, 10(6). https://doi.org/10.7759/CUREUS.2741

Porter, J. L., & Varacallo, M. (2022). Osteoporosis. https://www.ncbi.nlm.nih.gov/books/NBK441901/

Rahimizadeh, A., Asgari, N., & Rahimizadeh, A. (2018). Complete thoracolumbar fracture-dislocation with intact neurologic function: Explanation of a novel cord saving mechanism. The Journal of Spinal Cord Medicine, 41(3), 367. https://doi.org/10.1080/10790268.2017.1336300

Rosen, C. J. (2020). The Epidemiology and Pathogenesis of Osteoporosis. https://www.ncbi.nlm.nih.gov/books/NBK279134/

Schnake, K. J., Blattert, T. R., Hahn, P., Franck, A., Hartmann, F., Ullrich, B., Verheyden, A., Mörk, S., Zimmermann, V., Gonschorek, O., Müller, M., Katscher, S., Saman, A. el, Pajenda, G., Morrison, R., Schinkel, C., Piltz, S., Partenheimer, A., Müller, C. W., … Kandziora, F. (2018). Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Global Spine Journal, 8(2_suppl), 46S-49S. https://doi.org/10.1177/2192568217717972/ASSET/IMAGES/LARGE/10.1177_2192568217717972-FIG1.JPEG

Shi, G., Feng, F., Hao, C., Pu, J., Li, B., & Tang, H. (2020). A case of multilevel percutaneous vertebroplasty for vertebral metastases resulting in temporary paraparesis. The Journal of International Medical Research, 48(2). https://doi.org/10.1177/0300060519835084

Sozen, T., Ozisik, L., & Calik Basaran, N. (2017). An overview and management of osteoporosis. European Journal of Rheumatology, 4(1), 46–56. https://doi.org/10.5152/EURJRHEUM.2016.048

Starr, J., Tay, Y. K. D., & Shane, E. (2018). Current Understanding of Epidemiology, Pathophysiology, and Management of Atypical Femur Fractures. Current Osteoporosis Reports, 16(4), 519. https://doi.org/10.1007/S11914-018-0464-6

Sudo, H., Ito, M., Kaneda, K., Abumi, K., Kotani, Y., Nagahama, K., Minami, A., & Iwasaki, N. (2013). Anterior decompression and strut graft versus posterior decompression and pedicle screw fixation with vertebroplasty for osteoporotic thoracolumbar vertebral collapse with neurologic deficits. The Spine Journal : Official Journal of the North American Spine Society, 13(12), 1726–1732. https://doi.org/10.1016/J.SPINEE.2013.05.041

Svedbom, A., Hernlund, E., Ivergård, M., Compston, J., Cooper, C., Stenmark, J., McCloskey, E. v., Jönsson, B., & Kanis, J. A. (2013). Osteoporosis in the European Union: a compendium of country-specific reports. Archives of Osteoporosis, 8(1). https://doi.org/10.1007/S11657-013-0137-0

Table 8. [Focused Physical Examination in a Patient with Osteoporosis]. (2021).

Tutton, S. M., Pflugmacher, R., Davidian, M., Beall, D. P., Facchini, F. R., & Garfin, S. R. (2015). KAST Study: The kiva system as a vertebral augmentation treatment-A safety and effectiveness trial: A randomized, noninferiority trial comparing the kiva system with balloon kyphoplasty in treatment of osteoporotic vertebral compression fractures. Spine, 40(12), 865–875. https://doi.org/10.1097/BRS.0000000000000906

Urrutia, J., Besa, P., & Piza, C. (2019). Incidental identification of vertebral compression fractures in patients over 60 years old using computed tomography scans showing the entire thoraco-lumbar spine. Archives of Orthopaedic and Trauma Surgery, 139(11), 1497–1503. https://doi.org/10.1007/S00402-019-03177-9

Vaccaro, A. R., Oner, C., Kepler, C. K., Dvorak, M., Schnake, K., Bellabarba, C., Reinhold, M., Aarabi, B., Kandziora, F., Chapman, J., Shanmuganathan, R., Fehlings, M., & Vialle, L. (2013). AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine, 38(23), 2028–2037. https://doi.org/10.1097/BRS.0B013E3182A8A381

Varacallo, M. A., & Fox, E. J. (2014). Osteoporosis and its complications. The Medical Clinics of North America, 98(4), 817–831. https://doi.org/10.1016/J.MCNA.2014.03.007

Wang, F., & Zhu, Y. (2013). Treatment of complete fracture-dislocation of thoracolumbar spine. Journal of Spinal Disorders & Techniques, 26(8), 421–426. https://doi.org/10.1097/BSD.0B013E31824E1223

Wilson, N., Hurkmans, E., Adams, J., Bakkers, M., Baláaová, P., Baxter, M., Blavnsfeldt, A. B., Briot, K., Chiari, C., Cooper, C., Dragoi, R., Gäbler, G., Lems, W., Mosor, E., Pais, S., Simon, C., Studenic, P., Tilley, S., de La Torre, J., & Stamm, T. A. (2020). Prevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to consider. RMD Open, 6(1), e001143. https://doi.org/10.1136/RMDOPEN-2019-001143

Wood, K. B., Li, W., Lebl, D. S., & Ploumis, A. (2014). Management of thoracolumbar spine fractures. The Spine Journal : Official Journal of the North American Spine Society, 14(1), 145–164. https://doi.org/10.1016/J.SPINEE.2012.10.041

Xu, G. J., Li, Z. J., Ma, J. X., Zhang, T., Fu, X., & Ma, X. L. (2013). Anterior versus posterior approach for treatment of thoracolumbar burst fractures: a meta-analysis. European Spine Journal, 22(10), 2176. https://doi.org/10.1007/S00586-013-2987-Y

Zheng, Z., Johansson, H., Harvey, N. C., Lorentzon, M., Vandenput, L., Liu, E., Kanis, J. A., & McCloskey, E. v. (2022). Potential Adverse Effect of Nonsteroidal Anti‐Inflammatory Drugs (NSAIDs) on Bisphosphonate Efficacy: An Exploratory Post Hoc Analysis From a Randomized Controlled Trial of Clodronate. Journal of Bone and Mineral Research, 37(6), 1117. https://doi.org/10.1002/JBMR.4548

Additional Files

Published

2023-12-19