Effect of teriparatide compared with risedronate on back pain and incident vertebral fractures in postmenopausal women with osteoporotic vertebral fractures

CONTEXT AND OBJECTIVES: Controversy exists regarding the relationship between atherosclerosis and osteoporosis. The aim of this study was to determine the relationship between intima-media thickness (IMT) of the common carotid artery (CCA), presence of calcified atherosclerotic plaques and bone mineral density (BMD) evaluated by dual energy X-ray absorptiometry (DXA), in postmenopausal women. DESIGN AND SETTING: Cross-sectional study at Second Internal Medicine Clinic, Cluj-Napoca, Romania. METHODS: We studied the IMT (left and right CCA and mean IMT) and T-score (lumbar spine L2-L4, femoral neck and total hip) in 100 postmenopausal women (mean age 64.5 years). The presence of calcified atherosclerotic plaque and osteoporotic vertebral fractures was also noted. RESULTS: IMT in the left and right CCA and mean IMT were significantly associated with T-score measured for the lumbar spine L2-L4, femoral neck and total hip, with lower T-score, in the osteoporotic group than in the normal and osteopenic groups (P < 0.05). IMT had a significantly negative correlation with the lumbar spine T-score and femoral neck T-score; and mean IMT with lowest T-score. Mean IMT (P < 0.001), high blood pressure (P = 0.005) and osteoporotic vertebral fractures (P = 0.048) showed statistical significance regarding the likelihood of developing atherosclerotic plaque. CONCLUSIONS: In women referred for routine osteoporosis screening, the relationship between CCA, atherosclerosis and osteoporosis can be demonstrated using either cortical or trabecular BMD. Vertebral fractures may be considered to be a likelihood factor for atherosclerotic plaque development.

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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

Archives of Osteoporosis ◽

10.1007/s11657-019-0558-5 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 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.

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Effect of Alendronate on Limited-Activity Days and Bed-Disability Days Caused by Back Pain in Postmenopausal Women With Existing Vertebral Fractures

Archives of Internal Medicine ◽

10.1001/archinte.160.1.77 ◽

2000 ◽

Vol 160 (1) ◽

pp. 77 ◽

Cited By ~ 129

Author(s):

Michael C. Nevitt

Keyword(s):

Back Pain ◽

Postmenopausal Women ◽

Vertebral Fractures

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Distribution of Prevalent and Incident Vertebral Fractures and Their Association with Bone Mineral Density in Postmenopausal Women in the Teriparatide Versus Risedronate VERO Clinical Trial

Calcified Tissue International ◽

10.1007/s00223-020-00683-6 ◽

2020 ◽

Vol 106 (6) ◽

pp. 646-654

Author(s):

Piet Geusens ◽

David L. Kendler ◽

Astrid Fahrleitner-Pammer ◽

Pedro López-Romero ◽

Fernando Marin

Keyword(s):

Bone Mineral Density ◽

Clinical Trial ◽

Postmenopausal Women ◽

Bone Mineral ◽

Vertebral Fractures ◽

Mineral Density ◽

Incident Vertebral Fractures

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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

Osteoporosis International ◽

10.1007/s00198-020-05434-9 ◽

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

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

Journal of Neurosurgery Spine ◽

10.3171/spi.2002.97.3.0287 ◽

2002 ◽

Vol 97 (3) ◽

pp. 287-293 ◽

Cited By ~ 24

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.

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