Osteoporotic Unstable Scoliosis In Lumbar Spine Associated With Progressive Hemi-Vertebral Compression Fractures Following Long -Term Glucocortisone Therapy

10.5580/783 ◽  
2007 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Lumbar Spine ◽  
Vertebral Compression Fractures ◽  
Compression Fractures

Bone density and bone health alteration in boys with Duchenne Muscular Dystrophy: a prospective observational study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Renu Suthar ◽  
B. V. Chaithanya Reddy ◽  
Manisha Malviya ◽  
Titiksha Sirari ◽  
Savita Verma Attri ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Bone Health ◽  
Prospective Observational Study ◽  
Bone Fractures ◽  
Long Bone ◽  
Vertebral Compression Fractures ◽  
Serum Osteocalcin ◽  
Z Score ◽  
X Ray ◽  
Compression Fractures

Abstract Objectives Boys with Duchenne Muscular Dystrophy (DMD) are at increased risk for compromised bone health, manifesting as low-impact trauma long bone fractures and vertebral compression fractures. Methods In a prospective observational study, we studied bone health parameters in North Indian boys with DMD. We consecutively enrolled ambulatory boys with DMD on glucocorticoid therapy. Bone health was evaluated with X-ray spine, Dual-energy X-ray absorptiometry (DXA), serum calcium, vitamin D3 (25[OH]D), 1,25-dihyroxyvitamin D3 (1,25[OH]2D3), serum osteocalcin, osteopontin, and N terminal telopeptide of type 1 collagen (Ntx) levels. Results A total of 76 boys with DMD were enrolled. The median age was 8.5 (interquartile range [IQR] 7.04–10.77) years. Among these, seven (9.2%) boys had long bone fractures, and four (5.3%) had vertebral compression fractures. Fifty-four (71%) boys underwent DXA scan, and among these 31 (57%) had low bone mineral density (BMD, ≤−2 z-score) at the lumbar spine. The mean BMD z-score at the lumbar spine was −2.3 (95% confidence interval [CI] = −1.8, −2.8), and at the femoral neck was −2.5 (95% CI = −2, −2.9). 25(OH)D levels were deficient in 68 (89.5%, n=76) boys, and 1,25(OH)2D3 levels were deficient in all. Mean serum osteocalcin levels were 0.68 ± 0.38 ng/mL (n=54), serum osteopontin levels were 8.6 ± 4.6 pg/mL (n=54) and serum Ntx levels were 891 ± 476 nmol/L (n=54). Boys with low BMD received glucocorticoids for longer duration, in comparison to those with normal BMD (median, IQR [16.9 (6–34) months vs. 7.8 (4.8–13.4) months]; p=0.04). Conclusions Bone health is compromised in North Indian boys with DMD. BMD at the lumbar spine is reduced in more than half of boys with DMD and nearly all had vitamin D deficiency on regular vitamin D supplements. Longer duration of glucocorticoid therapy is a risk factor for low BMD in our cohort.

scholarly journals Analysis of two minimally invasive procedures for osteoporotic vertebral compression fractures with intravertebral cleft: a systematic review and meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hongyu Wei ◽  
Chunke Dong ◽  
Yuting Zhu ◽  
Haoning Ma
Keyword(s):  
Meta Analysis ◽  
Operation Time ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Controlled Trials ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Vertebral Height ◽  
Compression Fractures ◽  
Short And Long Term

Abstract Background A systematic review and meta-analysis to assess the pros and cons of percutaneous vertebroplasty (PVP) versus kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral cleft (IVC) including all available evidence from controlled trials. Methods Databases including Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched to identify relevant studies comparing PVP and PKP for OVCFs with IVC. The outcomes mainly included visual analog scale (VAS), Oswestry Disability Index (ODI), local kyphotic angle (LKA), rate of vertebral height (VH%), and adverse events. Results Nine studies enrolling 688 patients were eligible for meta-analysis. The results indicated no significant differences between the two groups in the short-and long-term VAS, ODI, LKA, or VH% (P > 0.05). Compared with PVP, PKP was associated with significantly longer operation time (P < 0.05), higher cost (P > 0.05), and more injected cement volume (P < 0.05). In terms of adverse events, PKP has a lower risk of cement leakage (P < 0.05), while with no significant difference in adjacent-level fracture rates (P > 0.05). Conclusion The two procedures have similar short- and long-term pain relief, functional recovery, local kyphosis correction, and vertebral height maintenance in OVCFs with IVC. PKP is superior to PVP for the injected cement volume, and lower cement leakage rate, however, with longer operation time, more fluoroscopy times, and higher cost. Further randomized controlled trials (RCTs) should be conducted to confirm these results.

scholarly journals Long-term skeletal consequences of childhood acute lymphoblastic leukemia in adult males: a cohort study

2013 ◽  
Vol 168 (2) ◽  
pp. 281-288 ◽  
Author(s):  
O Mäkitie ◽  
R Heikkinen ◽  
S Toiviainen-Salo ◽  
M Henriksson ◽  
L-R Puukko-Viertomies ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Lumbar Spine ◽  
Lymphoblastic Leukemia ◽  
Whole Body ◽  
Compression Fractures ◽  
Lower Lumbar Spine ◽  
Spinal Compression ◽  
Lower Lumbar

ObjectiveLong-term health sequelae of childhood-onset acute lymphoblastic leukemia (ALL) remain largely unknown. Low bone mineral content (BMC) and bone mineral density (BMD) are recognized complications, but it is unknown whether these persist until adulthood. We evaluated skeletal characteristics and their association with ALL therapy in long-term male ALL survivors.DesignThis cross-sectional cohort study included 49 long-term male ALL survivors and 55 age-matched healthy males.MethodsBMD and compression fractures were assessed by dual-energy X-ray absorptiometry; blood biochemistry was obtained for parameters of calcium homeostasis.ResultsThe ALL survivors (median age 29 years, range 25–38 years), assessed 10–38 years after ALL diagnosis, had lower lumbar spine (P<0.001), femoral neck (P<0.001), and whole-body (P=0.017) BMD than expected based on normative values. When compared with the controls (median age 30 years, range 24–36 years), the ALL survivors had lower lumbar spine BMC (P=0.014), lower whole-body BMC (P<0.001), and lower whole-body BMD (P<0.001), but the differences were partly explained by differences in height. Altogether, 20% of the ALL survivors had spinal compression fractures, but these were equally prevalent in the controls. Males diagnosed with ALL before age 5 years had significantly lower BMD values. Other recognized risk factors included untreated hypogonadism, vitamin D deficiency, hypophosphatemia, low IGF-binding protein-3, and low physical activity.ConclusionsAt young adulthood, long-term male ALL survivors have significantly reduced BMC and BMD and a high prevalence of spinal compression fractures. Careful follow-up and active treatment of the recognized risk factors are warranted.

scholarly journals Percutaneous Vertebroplasty for Pathological Vertebral Compression Fractures Secondary to Multiple Myeloma – Medium-Term and Long-Term Assessment of Pain Relief and Quality of Life

2015 ◽  
Vol 24 (4) ◽  
pp. 651-656 ◽  
Author(s):  
Artur Jurczyszyn ◽  
Ryszard Czepko ◽  
Mariusz Banach ◽  
Bartosz Godlewski ◽  
Przemysław Masłowski ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Myeloma ◽  
Pain Relief ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Compression Fractures ◽  
Medium Term ◽  
Compression Fractures

Peculiarities of Treatment of Patients with Complicated Compression Fractures of Thoracic and Lumbar Spine Vertebral Bodies on the Background of Osteoporosis

2009 ◽  
Vol 16 (2) ◽  
pp. 34-39
Author(s):  
S T Vetrile ◽  
Aleksandr Alekseevich Kuleshov ◽  
L Yu Darchiya ◽  
S T Vetrile ◽  
A A Kuleshov ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Term Treatment ◽  
Mineral Density ◽  
Compression Fractures ◽  
Long Term Treatment ◽  
Thoracic And Lumbar Spine ◽  
Vertebral Bodies ◽  
Adequate Decompression

Experience in surgical treatment of 11 patients (1998-2008) with complicated compression fractures of the thoracic and lumbar spine vertebral bodies on the background of osteoporosis has been presented. Mean age of patients was 58 years (from 37 to 74 years). The treatment consisted of the adequate decompression of spinal canal followed by correction and multilevel fixation of the spine with CDI system. Decision on the fixation extent was made with regard for the degree of bone mineral density and vertebral body injury. Follow up period made up 1-10 years. Long term treatment results were assessed clinically and roentgenologically. Correction of kyphosis was noted in all cases. In the late period slight loss of the achieved correction (within 12°) was observed but the patients did not complained of spinal pains. In patients operated on in early terms (up to 2 months) after neurologic complications development the more rapid regress of neurologic symptoms was noted. It was shown that differentiated approach to the choice of surgical technique enabled to achieve favorable results.

scholarly journals Kyphoplasty for Elderly Patients With Vertebral Compression Fractures—Do We Save Lives? Mortality Rates Analysis Comparison in a Long-Term Follow-Up Cohort

2021 ◽  
pp. 219256822098228
Author(s):  
Raphael Lotan ◽  
Yossi Smorgick ◽  
Yoram Anekstein ◽  
Oren Rudik ◽  
Ilia Prosso ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Retrospective Cohort ◽  
Mortality Rates ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Medical Centers ◽  
Significant Difference ◽  
Long Term Follow Up

Study Design: Retrospective cohort. Objectives: We aimed to compare a large cohort of patients with vertebral compression fractures (VCF) treated in 2 centers using different protocols (conservative vs BKP) and compare mortality rates on a long-term follow-up. Methods: Retrospective cohort held in 2 medical centers (W and AH). All patients admitted with VCF from November 2008 to January 2015 were enrolled in the study. Exclusion criteria were patients admitted with non-osteoporotic pathological fractures (such as metastatic or MM). Results: Our study included 208 patients treated for VCF, 127 were treated with BKP (88 females, 69.3%) and 81 were treated conservatively (59 females, 72.8%). Patients from Centre W were older and frailer compared to the patients from AH center (Average age 75.12 ± 11.16 vs 69.13 ± 9.61 years and Frailty score of 0.16 ± 0.1 vs 0.12 ± 0.1 respectively, T-test, p < 0.01 for both). Hazard ratios (HR) for age, female gender and frailty were significant for increased mortality, frailty had the highest HR of 182.42 (CI 29.05-1145.33, p < 0.01). Multivariate Cox model was fitted and after accounting for Gender, Age and Frailty, no significant difference was found between the 2 medical centers mortality rates (p = 0.59), thus no difference in mortality rates between BKP and conservative treatment in our study. Conclusion: long-term follow-up following BKP treatment for VCF did not show a reduced mortality rate compared to conservative treatment after accounting for frailty, age and gender. Frailty was the most important factor in predicting mortality. Further RCTs are needed to compare the quality of life differences between the 2 treatment strategies.

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