Current Management Principles of Osteoporosis Spine Fractures
DOI:
https://doi.org/10.31282/joti.v5n3.107Keywords:
Osteoporosis, Degenerative, Spine, Fracture, ManagementAbstract
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
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