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

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.

Download Full-text

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

Osteoporosis International ◽

10.1007/s00198-011-1856-y ◽

2011 ◽

Vol 23 (8) ◽

pp. 2141-2150 ◽

Cited By ~ 71

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

Download Full-text

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

Download Full-text

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.

Download Full-text