scholarly journals Effect of Bisphosphonates or Teriparatide on Mechanical Complications after Posterior Instrumented Fusion for Osteoporotic Vertebral Fracture: A Multi-center Retrospective Study

2020 ◽  
Author(s):  
Atsuyuki Kawabata ◽  
Toshitaka Yoshii ◽  
Takashi Hirai ◽  
Shuta Ushio ◽  
Takashi Kaito ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Vertebral Fractures ◽  
Complication Rate ◽  
Visual Analogue Scale Pain ◽  
Primary Osteoporosis ◽  
Mechanical Complication ◽  
Instrumented Fusion ◽  
Osteoporotic Vertebral Fractures ◽  
Posterior Instrumented Fusion ◽  
Reoperation Rates

Abstract Background: The optimal treatment of osteoporosis after reconstruction surgery for osteoporotic vertebral fractures (OVF) remains unclear. In this multicentre retrospective study, we investigated the effects of typically used agents for osteoporosis, namely, bisphosphonates (BP) and teriparatide (TP), on surgical results in patients with osteoporotic vertebral fractures. Methods: Retrospectively registered data were collected from 27 universities and affiliated hospitals in Japan. We compared the effects of BP vs TP on postoperative mechanical complication rates, implant-related reoperation rates, and clinical outcomes in patients who underwent posterior instrumented fusion for OVF and had been followed up at least for 2 years. Data were analysed according to whether the osteoporosis was primary or glucocorticoid-induced. Results: A total of 165 patients who underwent posterior instrumented fusion for OVF were included. The overall mechanical complication rate was significantly lower in the TP group than in the BP group (BP vs TP: 73.0% vs. 55.7%, p = 0.018). The screw backout rate was significantly lower and the rates of new vertebral fractures and pseudoarthrosis tended to be lower in the TP group than in the BP group. However, there were no significant differences in lumbar functional scores and visual analogue scale pain scores or in implant-related reoperation rates between the two groups. The incidence of pseudoarthrosis was significantly higher in patients with glucocorticoid-induced osteoporosis (GIOP) than in those with primary osteoporosis; however, the pseudoarthrosis rate was reduced by using TP. The use of TP also tended to reduce the overall mechanical complication rate in both primary osteoporosis and GIOP. Conclusions: The overall mechanical complication rate was lower in patients who received TP than in those who received a BP postoperatively, regardless of type of osteoporosis. The incidence of pseudoarthrosis was significantly higher in patients with GIOP, but the use of TP reduced the rate of pseudoarthrosis in GIOP patients.

scholarly journals Effect of Bisphosphonates or Teriparatide on Mechanical Complications after Posterior Instrumented Fusion for Osteoporotic Vertebral Fracture: A Multi-center Retrospective Study

2020 ◽  
Author(s):  
Atsuyuki Kawabata ◽  
Toshitaka Yoshii ◽  
Takashi Hirai ◽  
Shuta Ushio ◽  
Takashi Kaito ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Vertebral Fractures ◽  
Complication Rate ◽  
Visual Analogue Scale Pain ◽  
Primary Osteoporosis ◽  
Mechanical Complication ◽  
Instrumented Fusion ◽  
Osteoporotic Vertebral Fractures ◽  
Posterior Instrumented Fusion ◽  
Reoperation Rates

Abstract Background: The optimal treatment of osteoporosis after reconstruction surgery for osteoporotic vertebral fractures (OVF) remains unclear. In this multicentre retrospective study, we investigated the effects of typically used agents for osteoporosis, namely, bisphosphonates (BP) and teriparatide (TP), on surgical results in patients with osteoporotic vertebral fractures.Methods: Retrospectively registered data were collected from 27 universities and affiliated hospitals in Japan. We compared the effects of BP vs TP on postoperative mechanical complication rates, implant-related reoperation rates, and clinical outcomes in patients who underwent posterior instrumented fusion for OVF and had been followed up at least for 2 years. Data were analysed according to whether the osteoporosis was primary or glucocorticoid-induced.Results: A total of 165 patients who underwent posterior instrumented fusion for OVF were included. The overall mechanical complication rate was significantly lower in the TP group than in the BP group (BP vs TP: 73.0% vs. 55.7%, p = 0.018). The screw backout rate was significantly lower and the rates of new vertebral fractures and pseudoarthrosis tended to be lower in the TP group than in the BP group. However, there were no significant differences in lumbar functional scores and visual analogue scale pain scores or in implant-related reoperation rates between the two groups. The incidence of pseudoarthrosis was significantly higher in patients with glucocorticoid-induced osteoporosis (GIOP) than in those with primary osteoporosis; however, the pseudoarthrosis rate was reduced by using TP. The use of TP also tended to reduce the overall mechanical complication rate in both primary osteoporosis and GIOP. Conclusions: The overall mechanical complication rate was lower in patients who received TP than in those who received a BP postoperatively, regardless of type of osteoporosis. The incidence of pseudoarthrosis was significantly higher in patients with GIOP, but the use of TP reduced the rate of pseudoarthrosis in GIOP patients.

scholarly journals POS0016 THE EVALUATION OF FUNCTIONAL ABILITIES OF PATIENTS WITH OSTEOPOROTIC VERTEBRAL FRACTURES AS A BASIS FOR REHABILITATION PROGRAMS DEVELOPING

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 209.2-210
Author(s):  
L. Marchenkova ◽  
V. Vasileva ◽  
M. Eryomushkin
Keyword(s):  
Muscle Strength ◽  
Vertebral Fractures ◽  
Trunk Muscles ◽  
Control Group ◽  
Study Group ◽  
Primary Osteoporosis ◽  
X Rays ◽  
Functional Abilities ◽  
Rehabilitation Programs ◽  
Osteoporotic Vertebral Fractures

Background:Due to the demand for special rehabilitation programs for patients with osteoporotic vertebral fractures (VFs), it is of interest to study the functional abilities of those patients. The scientific hypothesis suggests that osteoporotic VFs would cause muscle weakness, muscle dysfunction and conditional disturbances.Objectives:to estimate muscle strength, motor function and coordination disorders in patients with VFs in the setting of systemic osteoporosis as a basis for rehabilitation programs developing.Methods:120 patients aged 43−80 with primary osteoporosis were enrolled. Study group comprised of 60 subjects (56 women, 4 men) with at least 1 VF confirmed by X-rays. Control group included 60 subjects (56 women, 4 men) with osteoporosis but without any osteoporotic fracture. The examination program included back muscles tenzodynamometry, balance tests and stabilometry.Results:Muscle strength deficiency was estimated in study group in trunk flexors (TF) — 40.9% and in trunk extensors (TE) — 18.1% with an adequate function of the left lateral flexors (LLF) and in right lateral flexors (RLF). Patients with VFs had the lower muscle strength vs controls of TE (15.64±9.8 vs 27.73±9.9 kg, p=0.00002), TF (14.61±8.98 vs 21.28±8.38 kg, p=0.0006), LLF (13.10±7.2 vs 24.06±8.9 kg, p=0.005) and RLF 13.44±7.43 vs 24.26±7.65 kg, p=0.0003). Patients with VFs lose their balance faster during one-leg-standing test with open eyes (5.0 [1.0; 10.0] vs 7.5 [5.0; 10.5] sec in control group, p=0.03) and with closed eyes (2.0 [0; 3.0] vs 3.5 [3.0; 5.0] sec, p=0.04). Fukuda-Unterberger test showed greater side dislocation in study group — 40° [25; 45] vs controls 30° [10; 45], (p=0.02). According to stabilometry study group was characterized vs control group by lower balance coefficient with open eyes (77.2±7.6 vs 85.7±9.4%, p=0.002) and with closed eyes (67.1±9.8 vs 73.4±9.9%, p=0.03), greater sagittal displacement (6.8 [2.1; 37.7] vs 4.8 [1.8; 10.7] mm, p=0.025) and deviation in the saggital plane (1.2 [-1.07; 1.5] vs -1.2 [-1.5; 1.2] mm, p=0.01), and also less pressure center velocity (9.51±4.4 vs 7.1±2.7 mm/sec, р=0.009).Conclusion:Osteoporotic VFs are associated with reduction of trunk muscles strength and negatively affect static and dynamic balance function that should be taken into account when developing rehabilitation programs for these patients.Disclosure of Interests:None declared.

scholarly journals Parathyroid Hormone Injection Versus Vertebroplasty in the Treatment of Osteoporotic Vertebral Fracture in Old Age: A Retrospective Study of 58 Female Patients

2020 ◽  
Author(s):  
Incheol Kook ◽  
Byeong-Jik Kang ◽  
Ye-Soo Park
Keyword(s):  
Parathyroid Hormone ◽  
Retrospective Study ◽  
Vertebral Fracture ◽  
Conservative Treatment ◽  
Vertebral Fractures ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Fracture ◽  
Group I ◽  
Osteoporotic Vertebral Fractures

Abstract Background: While the indications of parathyroid hormone (PTH) in osteoporosis prevention and management have been established, its indications in the treatment of osteoporotic vertebral fractures remain unknown. This study aimed to compare the effects of intervention (percutaneous vertebroplasty followed by anti-resorptive agents) and conservative treatment (PTH administration) in patients with osteoporotic vertebral fractures, as well as to investigate the optimal duration of PTH administration. Methods: A retrospective study was conducted using data of patients treated for osteoporotic vertebral fractures between January 2015 and November 2019. Treatment was selected based on the patient’s age, comorbidities, and patient’s preference after explaining the expected advantages and disadvantages of each treatment. Group C was administered PTH injections once weekly, whereas Group I underwent vertebroplasty followed by the administration of anti-resorptive agents. Radiological and clinical parameters were analyzed between two groups.Results: This study enrolled 58 patients (77 vertebrae). Group C included 24 patients (38 vertebrae) with average age of 77.50 ± 7.19 years (range, 65–85 years), average bone mineral density (BMD) of −3.39 ± 0.86 (range, −2.5 to −5.8), average follow-up period of 27.47 ± 7.60 weeks (range, 12–49 weeks). Group I included 34 patients (39 vertebrae) with an average age of 76.20 ± 8.67 years (range, 65–92 years), average BMD of −3.35 ± 0.91 (range, −2.5 to −5.1), average follow-up period of 30.82 ± 10.95 weeks (range, 16–59 weeks). There was no significant difference between the two groups in initial demographic, clinical and radiographic parameters. Group I showed significantly better clinical and radiological outcome during the last follow-up. Regarding side effects in Group C, two cases of dizziness (8.3%), nausea and vomiting (8.3%) were reported. In Group I, cement leakage was found in 26 vertebrae (66.7%), and cement leakage complications were observed in four patients (11.8%). Conclusion: Conservative treatment using PTH injection demonstrated slower pain relief and lesser suppression of vertebral height loss than vertebroplasty. However, PTH injection demonstrated a lower risk of procedure-related complications. The patient’s age, preference, and general condition with respect to the procedure’s risk should be considered when determining treatment options for osteoporotic vertebral fracture in old age.

scholarly journals Effect of Teriparatide on Subsequent Vertebral Fractures after Instrumented Fusion Surgery for Osteoporotic Vertebral Fractures with Neurological Deficits

2019 ◽  
Vol 13 (2) ◽  
pp. 283-289 ◽  
Author(s):  
Keishi Maruo ◽  
Toshiya Tachibana ◽  
Fumihiro Arizumi ◽  
Kazuki Kusuyama ◽  
Kazuya Kishima ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Neurological Deficits ◽  
Fusion Surgery ◽  
Instrumented Fusion ◽  
Osteoporotic Vertebral Fractures

scholarly journals The evaluation of functional abilities of patients with osteoporotic vertebral fractures as a basis for rehabilitation programs developing

2021 ◽  
Vol 19 (3) ◽  
pp. 152-159
Author(s):  
L. A. Marchenkova ◽  
E. V. Makarova ◽  
M. A. Eryomushkin ◽  
M. Yu. Герасименко ◽  
E. M. Styazkina ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Vertebral Fractures ◽  
Dynamic Balance ◽  
Trunk Muscles ◽  
Control Group ◽  
Study Group ◽  
Primary Osteoporosis ◽  
Functional Abilities ◽  
Rehabilitation Programs ◽  
Osteoporotic Vertebral Fractures

Background.Due to the demand for special rehabilitation programs for patients with osteoporotic vertebral fractures (VFs), it is of interest to study the functional abilities of those patients. The scientific hypothesis suggests that osteoporotic VFs would cause muscle weakness, muscle dysfunction and conditional (basic motor) disturbances. Objective:to estimate muscle strength, motor function and coordination disorders in patients with VFs in the setting of systemic osteoporosis as a basis for rehabilitation programs developing. Methods. 120 patients aged 4380 with primary osteoporosis were enrolled. Study group comprised of 60 subjects (56 women, 4 men) with at least 1 VF confirmed by X-ray. Control group included 60 subjects (56 women, 4 men) with osteoporosis but without any osteoporotic fracture. The examination program consist of back muscles tenzodynamometry, balance tests and stabilometry. Results. Muscle strength deficiency was estimated in study group in trunk flexors (TF) 40.9% and in trunk extensors (TE) 18.1% with an adequate function of the left lateral flexors (LLF) and in right lateral flexors (RLF). Patients with VFs had the lower muscle strength vs controls of TE (15.64 9.8 vs 27.73 9.9 kg, p = 0.00002), TF (14.61 8.98 vs 21.28 8.38 kg, p = 0.0006), LLF (13.10 7.2 vs 24.06 8.9 kg, p = 0.005) and RLF 13.44 7.43 vs 24.26 7.65 kg, p = 0.0003). Patients with VFs lose their balance faster during one-leg-standing test with open eyes (5.0 [1.0;10.0]vs 7.5 [5.0;10.5]sec in control group, p=0.03) and with closed eyes (2.0[0;3.0] vs 3.5[3.0;5.0]sec, p = 0.04). Fukuda-Unterberger test showed greater side dislocation in study group 40 [25;45]vs controls 30 [10; 45], (p=0.02). According to stabilometry study group was characterized vs control group by lower balance coefficient with open eyes (77.27.6 vs 85.79.4%, p=0.002) and with closed eyes (67.19.8 vs 73.49.9%, p=0.03), greater sagittal displacement(6.8 [2.1;37.7]vs4.8 [1.8;10.7]mm, p=0.025) and deviation in the saggital plane(1.2 [-1.07;1.5]vs-1.2 [-1.5;1.2]mm, p = 0.01), and also less pressure center velocity (9.51 4.4 vs 7.1 2.7 mm/sec, р=0.009). Conclusions.VFs in osteoporotic patients are associated with reduction of trunk muscles strength and negatively affect static and dynamic balance function. The obtained data should be taken into account when developing rehabilitation programs for patients with osteoporosis who have suffered compression VFs.

Relationship Between the OF Classification and Radiological Outcome of Osteoporotic Vertebral Fractures After Kyphoplasty

2020 ◽  
pp. 219256822096405
Author(s):  
Yannick Palmowski ◽  
Sophie Balmer ◽  
Zhouyang Hu ◽  
Tobias Winkler ◽  
Klaus John Schnake ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Vertebral Fractures ◽  
Body Height ◽  
Postoperative Outcome ◽  
Osteoporotic Fractures ◽  
Preoperative Assessment ◽  
Visual Analogue Scale Pain ◽  
Vertebral Body Height ◽  
Osteoporotic Vertebral Fractures ◽  
Clinical And Radiological Results

Study Design: Retrospective cohort study. Objectives: The OF classification is a new classification for osteoporotic vertebral fractures. The aim of this study was to clarify the relationship between preoperative OF subgroups and the postoperative outcome after kyphoplasty in patients with such fractures. Methods: Patients who underwent kyphoplasty of a single osteoporotic vertebral fracture were included and divided into groups according to the OF subgroups. Pre- and postoperative plain radiographs were analyzed in regard to the restoration of vertebral body height and local kyphotic angle (LKA). Additionally, clinical data including pre- and postoperative Visual Analogue Scale pain scores was documented. The clinical and radiological results were compared pre- and postoperatively within groups and between groups. Results: A total of 156 patients from OF subgroups 2 to 4 were included (OF 2: n = 58; OF 3: n = 36; OF 4: n = 62). Patients from all groups experienced significant pain relief postoperatively ( P < .001). Patients with OF 2 fractures showed a repositioning of the vertebral body height in the anterior and middle portions (both P < .001), but no significant improvement in LKA. For OF 3 and 4 fractures, there was a significant restoration of vertebral body height ( P < .001 for both) and a significant improvement of LKA ( P < .001 for both). The highest average restoration was noted in the OF 4 group. Conclusions: A higher OF subgroup is related to a higher radiological benefit from kyphoplasty. This confirms that the OF classification is an appropriate tool for the preoperative assessment of osteoporotic fractures.

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