scholarly journals Earlier Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture May Minimize the Subsequent Development of Adjacent Fractures: A Retrospective Study

2018 ◽  
Vol 1 (21;1) ◽  
pp. E483-E491
Author(s):  
Ru-Ping Lee
Keyword(s):  
Bone Mineral Density ◽  
Retrospective Study ◽  
Bone Mineral ◽  
Symptom Onset ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Mineral Density ◽  
Fracture Development ◽  
Thoracolumbar Region ◽  
Adjacent Fractures

Background: Percutaneous vertebroplasty (PVP) is widely used to treat osteoporotic vertebral compression fractures (OVCFs). The influence of timing (early vs. late) of PVP on the development of adjacent vertebral fractures (AVF) has rarely been discussed. Objective: This study aimed to compare the incidence of AVF among patients who received early PVP (≤ 30 days after symptom onset, EPVP) or late PVP (> 30 days after symptom onset, LPVP) in the thoracolumbar region (T10 to L2) after a 1-year follow up. Study Design: A retrospective cohort study. Setting: Department of Orthopedic, an affiliated hospital of a medical university. Methods: Patients who had single-level, T-score ≤ -2.5 of lumbar bone mineral density (BMD), primary OVCF in the thoracolumbar region (T10 to L2) and who received PVP between July 2012 and June 2014 were included in the study. They were divided into early PVP and late PVP groups according to the interval between symptom onset and treatment. The risk factors associated with subsequent AVFs were analyzed. Results: Of the 225 patients reviewed, 124 met the criteria and were followed for a minimum of 1 year. Eleven patients (14.1%) in the EPVP group (n = 78) and 18 patients (39.1%) in the LPVP group (n = 46) experienced an AVF during the first year following vertebroplasty. Outcomes were significantly better in patients with higher bone mineral density, lower cement volume, and without cement leakage (P < 0.01). Cox regression indicated an increase risk for AVF for LPVP, with an adjusted hazard ratio of 6.08 (95% confidence interval: 2.50–14.81). Limitation: The incidence of AVFs could be over estimated due to this being a retrospective study with a small case number and lack of either biomechanical study of intra-vertebral cement distribution by times to support the result. Conclusions: Compared with later interventions, PVP performed within 30 days after fracture development may be associated with a lower risk of adjacent fractures in the thoracolumbar region. Key words: Percutaneous vertebroplasty, osteoporosis, osteoporotic vertebral compression fracture, adjacent vertebral fracture

scholarly journals Sleep onset latency is related with reduced bone mineral density in elderly people with insomnia: a retrospective study

2018 ◽  
Vol Volume 13 ◽  
pp. 1525-1530 ◽  
Author(s):  
Qian Tong ◽  
Wanzhen Wu ◽  
Qing Wu ◽  
Yanbo Yu ◽  
Xiaoling Lv ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Retrospective Study ◽  
Elderly People ◽  
Bone Mineral ◽  
Sleep Onset ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Mineral Density

scholarly journals Rebound-Associated Vertebral Fractures Two Months After a Missed Dose of Denosumab

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A218-A218
Author(s):  
Ahl Jeffrey Caseja ◽  
Najwa Abdullah ◽  
Samer Nakhle
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Epigastric Pain ◽  
Incidental Finding ◽  
Compression Fracture ◽  
Prior History ◽  
Mineral Density ◽  
Work Up

Abstract Introduction: Denosumab, an anti-resorptive medication approved for treatment of osteoporosis, increases bone mineral density and reduces fracture risk. Discontinuation of treatment is associated with bone turnover rebound and reduced bone mineral density. We report a case of a woman without prior history of fragility fractures who presented with multiple spontaneous vertebral fractures two months after a missed dose of Denosumab, which is earlier than current available literature. Clinical Case: A 54-year old female was diagnosed with osteoporosis at the age of 50 with a DXA revealing T-scores of LS -2.9 SD, LFN -0.6 SD, TH -0.5 SD. Ten-year probability of MOF evaluated by FRAX was 6%. Work-up for secondary causes of osteoporosis during the time was unremarkable. She was started on Denosumab 60 mg every 6 months from July 2016 to July 2019, receiving a total of 5 injections. She had missed her dose of Denosumab in January 2020. Two months after the missed dose, she presented to a local hospital with complaints of chest and epigastric pain. A CTA was performed as part of evaluation which was unremarkable aside from an incidental finding of thoracic compression fractures. An MRI of the spine was subsequently done which showed a recent-appearing moderate to severe wedge compression fracture and edema of the T7 and T6 vertebral bodies, and of the upper two-thirds of the T4. A biological and radiological work-up to exclude other causes of osteoporosis to explain the patient’s vertebral fractures was performed. The patient did not have renal failure, vitamin D deficiency, hyperthyroidism, primary hyperparathyroidism, Cushing’s disease, hypophosphatemia, multiple myeloma, Celiac disease, diabetes mellitus, or prior glucocorticoid treatment. During the time of treatment and discontinuation of Denosumab, the patient was on adequate supplementation of calcium and Vitamin D. The patient’s vertebral fractures were treated with kyphoplasty. To treat osteoporosis and prevent further risk of fractures, she was started on an anabolic agent Abaloparatide. Conclusion: This case demonstrates rebound vertebral fractures occurring very shortly after discontinuing Denosumab in a relatively young woman with low probability of major osteoporotic fracture. Further investigation must be done to determine pathophysiological process involved of vertebral fractures and treatment regimen after sudden discontinuation of Denosumab.

scholarly journals Gender aspects of osteoporosis and their relationship to calcium balance

2017 ◽  
Vol 98 (3) ◽  
pp. 343-348 ◽  
Author(s):  
L A Fomina ◽  
I A Zyabreva
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Tissue ◽  
Bone Mineral ◽  
Health Examination ◽  
Calcium Balance ◽  
Z Score ◽  
Mineral Density ◽  
Blood Calcium ◽  
Fracture Development

Aim. To evaluate the state of bone tissue in comparison with calcium balance, to clarify the risk for fracture development in women of different age groups. METHODS. 92 females aged 19 to 89 years were examined clinically with densitometry of lumbar spine and femoral neck and measuring the concentration of total calcium in the blood. RESULTS. In females younger than 50 years decreased bone density according to Z-score was revealed in 30% of cases, among patients with its normal values significant trend to bone rarefaction (-2.0 SD <Z-score ≤-1.5 SD) was registered with the same rate. In the group of females older than 50 years osteopenia was revealed in 46.3% of cases and osteoporosis - in 42.7%, while more significant decrease in bone mineral density was found in the lumbar spine. Past medical history of fractures increased the rate of osteoporosis by 18%. In females older than 50 years compared to younger patients a significant increase of blood calcium concentration was revealed. Besides, statistically significant increase of its level was noted in cases of fractures in the past and osteoporosis. The revealed changes of bone tissue in females below 50 years of age are indicative of increased risk of osteoporosis development in the future. CONCLUSION. High prevalence of osteoporosis and osteopenia is revealed in the examined patients older than 50 years, and bone mineral density parameters were significantly inversely correlated with calcemia; hence, blood calcium level can be one of the criteria of bone tissue state and in combination with other risk factors for osteoporosis should be taken into account during periodic health examination of females older than 50 years.

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