Fragility Vertebral Compression Fractures in Postmenopausal Women: The Role of a Fracture Liaison Service Program

Jackson, Avery; Wasfie, Tarik; Brock, Caramarie; Galovska, Stefanija; Smalley, Melany; Grundman, Kendra; Hella, Jennifer

doi:10.1177/0003134820933254

Cited by 8 publications

(6 citation statements)

References 11 publications

(13 reference statements)

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“…A prominent strategy to address this crisis has been the widespread adoption of FLS programs, which have proved effective in improving rates of osteoporosis management and reducing rates of secondary fragility fractures in certain studies 34 - 38 . However, such initiatives are not universally associated with improved outcomes 39 , 40 .…”

Section: Discussionmentioning

confidence: 99%

Rates of Osteoporosis Management and Secondary Preventative Treatment After Primary Fragility Fractures

et al. 2021

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Background: Fragility fractures are often sentinel events in documenting new cases of osteoporosis. Numerous analyses have demonstrated low rates of adequate osteoporosis evaluation and treatment following primary fragility fractures. The purpose of this study was to quantify the incidence of primary fragility fractures in America and the rates of osteoporosis screening and management before and after fracture. Methods: A retrospective review of the PearlDiver database was conducted using the International Classification of Diseases, Ninth Revision (ICD-9) and ICD, Tenth Revision (ICD-10) and Current Procedural Terminology codes. Patients who were 60 to 80 years of age and had primary fragility fractures of the hip, wrist, spine, pelvis, humerus, and other unspecified locations were included. The rates of dual x-ray absorptiometry (DXA) screening and osteoporosis pharmacotherapy were assessed for 2 years before and 2 years after the primary fracture. Results: In this study, 48,668 patients with a primary fragility fracture were identified. Within this cohort, 25.8% (12,573 of 48,668) had received osteoporosis screening or treatment in the prior 2 years. In the 36,095 patients with no management before the fracture, 19% (6,799 patients) were diagnosed with osteoporosis and 18.4% (6,653 patients) received a DXA scan and/or filed claims for pharmacotherapy in the following 2 years. Patients with an osteoporosis diagnosis were more likely to receive both types of management (odds ratio [OR], 11.55 [95% confidence (CI), 10.31 to 12.95]), and male patients were less likely to receive both types of management (OR, 0.23 [95% CI, 0.17 to 0.27]). Secondary fragility fractures within the next 2 years were diagnosed in 8.4% (3,038 of 36,095) of patients at a mean of 221 days following the primary fracture. Conclusions: The rates of appropriate osteoporosis evaluation, diagnosis, and management following primary fragility fractures remain unacceptably low. Less than one-third of patients with primary fragility fractures had been evaluated or treated for osteoporosis in the 2 years prior to fracture. Furthermore, among patients without pre-fracture management, <20% received osteoporosis screening or treatment within the next 2 years. Level of Evidence: Prognostic Level IV . See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Rates of Osteoporosis Management and Secondary Preventative Treatment After Primary Fragility Fractures

et al. 2021

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“…Particularly among women, there are approximately 1.5 million OVCF patients each year. [ 3 , 4 ] At present, there are surgical and nonsurgical methods for the treatment of OVCF. nonoperative methods include taking painkillers, wearing back braces, and bed rest to improve functional status and preventing future fractures of other vertebral bodies.…”

Section: Introductionmentioning

confidence: 99%

Effect of different bone cement distributions in percutaneous kyphoplasty on clinical outcomes for osteoporotic vertebral compression fractures: A retrospective study

et al. 2023

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Osteoporotic fractures and their complications are becoming increasingly harmful to the elderly. This study aimed to evaluate the clinical results of connected or unconnected bilateral cement after bilateral percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures (OVCF). The clinical data of 217 patients with single-segment OVCF were retrospectively collected. Patients were allocated into 2 groups according to the bilateral bone cement in the vertebrae was connected or unconnected after surgery. The surgery-related indexes of the 2 groups were compared, including operation time; bone cement injection volume; contact situation between bone cement and the upper and lower endplates of the vertebral body; visual analogue scale (VAS) scores before surgery, 1 week and 1 year after surgery; Oswestry disability index (ODI) before surgery, 1 week and 1 year after surgery; local kyphosis angle (LKA) before surgery, 1 week and 1 year after surgery; postoperative vertebral body height at 1 week and 1 year after surgery; vertebral body height restoration rate (HRR) at 1 week and 1 year after surgery. The follow-up results of all patients were recorded. The postoperative VAS, ODI, vertebral body height, LKA and other indexes of the 2 groups were significantly improved compared with those before the operation ( P < .05), and there was no significant difference between the 2 groups ( P > .05). At the same time, there were no significant difference in vertebral body HRR and bone cement leakage rate between the 2 groups ( P > .05). X-ray examination showed that 21 of 217 patients (21/217, 9.8%) had a refracture of the injured vertebral body, including 16 cases (16/121, 13.2%) in the unconnected group and 5 cases (5/96, 5.2%) in the connected group ( P < .05). Adjacent vertebrae fractures occurred in 25 cases (25/217, 11.5%), while 19 cases (19/121, 15.7%) were in the unconnected group and 6 cases (6/96, 6.3%) were in the connected group ( P < .05). PKP has a good therapeutic effect on OVCF no matter whether the bilateral bone cement is connected or not. However, if the bilateral cement inside the vertebra was connected, the risk of recollapse of the injured vertebrae and the new fracture of adjacent vertebrae could be reduced.

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“…Due to the social aging, the incident rate of osteoporotic vertebral compression fracture has increased year by year with its insidious onset and low consultation rate seriously threatening the health of the elderly, which is more signi cant in postmenopausal women [1][2][3]. In view of the actual clinical problems, researches on OVCF have become urgent and necessary [4,5]. Patients with osteoporotic vertebral compression fractures mainly feature low back pain and aggravated postural changes with spinal deformation, decreased cardiopulmonary function and gastrointestinal instabilityin severe cases, and even spinal nerve compression leading to paralysis and life-threatening conditions [6].…”

Section: Introductionmentioning

confidence: 99%

Study on the Therapeutic Effect of ESPB for Patients Undergoing Percutaneous Vertebroplasty

Peng

Jiang

2022

Preprint

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Objective To compare the difference oftherapeutic effect between percutaneous vertebroplasty (PVP)alone and PVP + Erector spinal plane block (ESPB) in the treatment of osteoporotic vertebral compression fracture (OVCF). Methods After admission, 100 patients with osteoporotic vertebral compression fracture were randomly divided into PVP group (control group) and PVP+ESPB group (observation group) by lottery with 50 patients in each group.The visual analog pain scores (VAS) and oswestry disability index (ODI) of each group were compared before surgery, 2 hours after surgery and at the time of hospital discharge. The operation time, filling volume of intraoperative bone cement, intraoperative bloodloss, and surgery cost of each group were compared.Theearly postoperative ambulation time and early postoperative defecation (stool) time ofeach group were compared to explore the difference.Results The PVP+ESPB group had better visual analog pain scores (VAS) and oswestry disability index (ODI) at 2 hours after surgery and at the time of hospital discharge, and better early postoperative ambulation timeand early postoperative defecation (stool) timethan the PVP group (p<0.05). There were no differences in the visual analog pain scoresand oswestry disability index before surgery, operative time, filling volume of intraoperative bone cement, intraoperative blood loss, and surgery cost between the two groups, and no complications occurred between the two groups after surgery and at the time of hospital discharge. Conclusion PVP+ESPB for OVCF is associated with lower VAS, more significant pain relief, and lower oswestry disability index in patients after surgery than PVP alone for OVCF, and patients are able to engage in ambulation time earlier. Meanwhile, PVP+ESPB promotes recovery of intestinalfunction and improves patients’ quality of life so as tocontribute toquick recovery.

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Fragility Vertebral Compression Fractures in Postmenopausal Women: The Role of a Fracture Liaison Service Program

Cited by 8 publications

References 11 publications

Rates of Osteoporosis Management and Secondary Preventative Treatment After Primary Fragility Fractures

Rates of Osteoporosis Management and Secondary Preventative Treatment After Primary Fragility Fractures

Effect of different bone cement distributions in percutaneous kyphoplasty on clinical outcomes for osteoporotic vertebral compression fractures: A retrospective study

Study on the Therapeutic Effect of ESPB for Patients Undergoing Percutaneous Vertebroplasty

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