Back pain from painful osteoporotic vertebral fractures: discrepancy between the actual fracture location and the location suggested by patient-reported pain or physical examination findings

2020 ◽  
Vol 31 (9) ◽  
pp. 1721-1732
Author(s):  
H. Jin ◽  
X. Ma ◽  
Y. Liu ◽  
M. Liu ◽  
X. Yin ◽  
...  
Keyword(s):  
Back Pain ◽  
Physical Examination ◽  
Vertebral Fractures ◽  
Fracture Location ◽  
Osteoporotic Vertebral Fractures ◽  
Patient Reported ◽  
Actual Fracture

scholarly journals An observational cohort study to produce and evaluate an improved tool to screen older women with back pain for osteoporotic vertebral fractures (Vfrac): study protocol

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
T. K. Khera ◽  
A. Burston ◽  
S. Davis ◽  
S. Drew ◽  
R. Gooberman-Hill ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Back Pain ◽  
Older Women ◽  
Vertebral Fractures ◽  
Screening Tool ◽  
Observational Cohort Study ◽  
Binary Output ◽  
Osteoporotic Vertebral Fractures ◽  
Observational Cohort

Abstract Summary The aim of this study is to produce an easy to use checklist for general practitioners to complete whenever a woman aged over 65 years with back pain seeks healthcare. This checklist will produce a binary output to determine if the patient should have a radiograph to diagnose vertebral fracture. Purpose People with osteoporotic vertebral fractures are important to be identified as they are at relatively high risk of further fractures. Despite this, less than a third of people with osteoporotic vertebral fractures come to clinical attention due to various reasons including lack of clear triggers to identify who should have diagnostic spinal radiographs. This study aims to produce and evaluate a novel screening tool (Vfrac) for use in older women presenting with back pain in primary care based on clinical triggers and predictors identified previously. This tool will generate a binary output to determine if a radiograph is required. Methods The Vfrac study is a two-site, pragmatic, observational cohort study recruiting 1633 women aged over 65 years with self-reported back pain. Participants will be recruited from primary care in two sites. The Vfrac study will use data from two self-completed questionnaires, a simple physical examination, a lateral thoracic and lateral lumbar radiograph and information contained in medical records. Results The primary objective is to develop an easy-to-use clinical screening tool for identifying older women who are likely to have vertebral fractures. Conclusions This article describes the protocol of the Vfrac study; ISRCTN16550671.

The effect of teriparatide compared with risedronate on reduction of back pain in postmenopausal women with osteoporotic vertebral fractures

2011 ◽  
Vol 23 (8) ◽  
pp. 2141-2150 ◽  
Author(s):  
P. Hadji ◽  
J. R. Zanchetta ◽  
L. Russo ◽  
C. P. Recknor ◽  
K. G. Saag ◽  
...  
Keyword(s):  
Back Pain ◽  
Postmenopausal Women ◽  
Vertebral Fractures ◽  
Osteoporotic Vertebral Fractures

Percutaneous transpedicular vertebroplasty with calcium phosphate cement in the treatment of osteoporotic vertebral compression and burst fractures

2002 ◽  
Vol 97 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Masato Nakano ◽  
Norikazu Hirano ◽  
Kousou Matsuura ◽  
Hiroki Watanabe ◽  
Hideki Kitagawa ◽  
...  
Keyword(s):  
Back Pain ◽  
Calcium Phosphate ◽  
Pain Relief ◽  
Vertebral Fractures ◽  
Calcium Phosphate Cement ◽  
Content Type ◽  
Osteoporotic Vertebral Fractures ◽  
The Mean ◽  
Fine Print

Object. Osteoporotic vertebral fractures occasionally lead to late-onset collapse, kyphosis, persistent back pain, and disability. The authors describe a series of patients in whom they performed percutaneous vertebroplasty by using calcium phosphate cement (CPC) to obtain early pain relief and improve the integrity of the osteoporotic vertebral body (VB). Methods. Between August 2000 and February 2001, they performed 17 percutaneous transpedicular CPC-assisted vertebroplasty procedures in 16 patients who harbored thoracic or lumbar osteoporotic vertebral fractures. Following repositioning and curettage of the pathological soft tissues, CPC-assisted vertebroplasty was percutaneously performed in four patients with osteoporotic burst fracture and pseudarthrosis (Procedure A). In situ CPC-assisted vertebroplasty was performed in 12 patients with fresh vertebral compression fractures due to osteoporosis (Procedure B). Back pain and low-back pain were evaluated using a visual analog scale (VAS). The deformity index of the VB was measured on a lateral radiograph as the ratio of the VB's height (sum of measurements at anterior, middle, and posterior regions) to its longitudinal diameter. Based on VAS scores, pain was decreased in all patients immediately after surgery, and pain relief was maintained at the last follow up. The mean preoperative deformity index score of the VB was 1.43 in Procedure A and 1.67 in Procedure B; postoperatively scores improved to 1.59 and 1.93, respectively. At the 6-month follow-up examination, the mean deformity index score rebounded to 1.52 in Procedure A and 1.79 in Procedure B. Bone union was documented in all patients. Complications, such as a temporary respiratory insufficiency and a small amount of CPC leakage into the spinal canal, were observed in patients who underwent Procedure B. Conclusions. Percutaneous transpedicular CPC-assisted vertebroplasty is a minimally invasive procedure that provides early relief of pain and prevents vertebral collapse and pseudarthrosis in patients with osteoporotic vertebral fracture.

Denosumab and alendronate treatment in patients with back pain due to fresh osteoporotic vertebral fractures

2017 ◽  
Vol 22 (2) ◽  
pp. 230-236 ◽  
Author(s):  
Tomoko Tetsunaga ◽  
Tomonori Tetsunaga ◽  
Keiichiro Nishida ◽  
Masato Tanaka ◽  
Yoshihisa Sugimoto ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Osteoporotic Vertebral Fractures ◽  
Alendronate Treatment

Back pain in osteoporotic vertebral fractures

2007 ◽  
Vol 19 (7) ◽  
pp. 895-903 ◽  
Author(s):  
R. M. Francis ◽  
T. J. Aspray ◽  
G. Hide ◽  
A. M. Sutcliffe ◽  
P. Wilkinson
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Osteoporotic Vertebral Fractures

scholarly journals Vfrac – a simple clinical tool that identifies older women with back pain at high risk of osteoporotic vertebral fractures

Bone Reports ◽  
2021 ◽  
Vol 14 ◽  
pp. 100958
Author(s):  
Emma Clark ◽  
Sarah Davis ◽  
Rachael Gooberman-Hill ◽  
Linda Hunt ◽  
Tarnjit Khera ◽  
...  
Keyword(s):  
Back Pain ◽  
High Risk ◽  
Older Women ◽  
Vertebral Fractures ◽  
Clinical Tool ◽  
Osteoporotic Vertebral Fractures

Union rates and prognostic variables of osteoporotic vertebral fractures treated with a rigid external support

2012 ◽  
Vol 17 (5) ◽  
pp. 469-475 ◽  
Author(s):  
Kenji Murata ◽  
Goichi Watanabe ◽  
Satoshi Kawaguchi ◽  
Kohei Kanaya ◽  
Keiko Horigome ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Japanese Orthopaedic Association ◽  
External Support ◽  
Prognostic Variables ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference ◽  
External Supports

Object External supports serve as a traditional treatment option for osteoporotic vertebral fractures (OVFs). However, the role of external supports in the treatment of OVF remains inconclusive. The purpose of this study was to determine the role of a rigid external support in the healing of OVFs by prospectively evaluating union (fracture settling) rates and prognostic variables for patients suffering from an incident OVF. Methods Fifty-five patients with acute back pain were enrolled in this study after being diagnosed with an OVF based on MRI findings. Patients were treated using a plastic thoracolumbosacral orthosis (TLSO) and underwent follow-up at 2, 3, and 6 months. Vertebrae were referred to as “settled” when there was no dynamic mobility on sitting lateral and supine lateral radiographs. At the time of the 3- and 6-month follow-up visits, the patients were divided into 2 groups, the “settled group” and the “unsettled group.” Patients in these groups were compared with regard to clinical and radiographic features. Results Of the 55 patients enrolled, 53 patients were followed up for 6 months. There were 14 men and 39 women with an average age of 75.3 years. Fracture settling of the affected vertebra was defined in 54.7% of the patients at 2 months, in 79.2% at 3 months, and in 88.7% at 6 months. All 5 components of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire improved significantly both at 3 months and 6 months. Patients in the unsettled group exhibited a statistically greater likelihood of having fractures at the thoracolumbar junction, Type A3 fractures, and fractures with a diffuse low-intensity area on T2-weighted MRI studies at 3 months. In contrast, at 6 months, the only statistically significant difference between the groups was patient age. Conclusions The biomechanical disadvantages of OVFs (location, type, and size) adversely influencing the fracture healing were overcome by the treatment using a TLSO within 6 months. The authors' findings show that a TLSO plays a biomechanical role in the healing of OVFs.

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