Management of the Elderly With Vertebral Compression Fractures.

Vertebral compression fractures (VCFs) are the most common type of fracture secondary to osteoporosis. These fractures are associated with significant rates of morbidity and mortality and annual direct medical expenditures of more than $1 billion in the United States. Although many patients will respond favorably to nonsurgical care of their VCF, contemporary natural history data suggest that more than 40% of patients may fail to achieve significant pain relief within 12 months of symptom onset.

Fragility fractures of the pelvis: should they be fixed?

Due to the aging population, there is an increasing number of fragility fractures of the pelvis (FFP). They are the result of low energy trauma. The bone breaks but the ligaments remain intact.

Morbidity and Mortality After Vertebral Fractures: Comparison of Vertebral Augmentation and Nonoperative Management in the Medicare Population.

Study Design: Vertebral compression fracture (VCF) patients in the 100% US Medicare data set (2005-2009).

Objective: To compare the mortality and morbidity risks for VCF patients undergoing conservative treatment (nonoperated), balloon kyphoplasty (BKP), and vertebroplasty (VP).

Summary Of Background Data: Studies have reported lower mortality risk for BKP or VP cohorts than nonoperated cohorts, but it is uncertain whether there are any differences in morbidity risks.

Comparison of Effects of Nonoperative Treatment and Decompression Surgery on Risk of Patients with Lumbar Spinal Stenosis Falling: Evaluation with Functional Mobility Tests.

Background: Falls are a major factor contributing to fragility fractures. Patients with lumbar spinal stenosis have an increased risk of falling. We are aware of no prior report demonstrating the effect of medical treatment and decompression surgery on the risk of patients with lumbar spinal stenosis falling.

Bracing for thoracolumbar fractures.

Traumatic fractures of the thoracolumbar spine are relatively common occurrences that can be a source of pain and disability. Similarly, osteoporotic vertebral fractures are also frequent events and represent a significant health issue specific to the elderly. Neurologically intact patients with traumatic thoracolumbar fractures can commonly be treated nonoperatively with bracing.

Management of thoracolumbar spine fractures.

Background Context: Traumatic fractures of the spine are most common at the thoracolumbar junction and can be a source of great disability.

Purpose: To review the most current information regarding the pathophysiology, injury pattern, treatment options, and outcomes.

Study Design: Literature review.

Comparing pain reduction following vertebroplasty and conservative treatment for osteoporotic vertebral compression fractures: a meta-analysis of randomized controlled trials.

Background: Osteoporotic vertebral compression fractures (OVCFs) are the most common osteoporotic fractures. Pain is the main symptom. Percutaneous vertebroplasty (PVP) is a therapeutic procedure performed to reduce pain in vertebral compression fractures.

Vertebral augmentation versus conservative therapy for emergently admitted vertebral compression deformities: an economic analysis.

Background: Vertebral augmentation (VA) performed on inpatients with painful osteoporotic vertebral compression fractures (VCFs) has been shown to facilitate discharge, decrease analgesic requirements, and improve pain.

Objective: The purpose of our study was to compare the overall cost, length of stay, and readmission data for patients hospitalized with painful osteoporotic VCFs, treated either medically or with inpatient VA.

Setting: A single academic medical center.

Osteoporotic vertebral compression fractures: surgery versus non-operative management.

This 12-month retrospective study compared pain relief, quality of life (QoL), treatment cost-effectiveness and complication rates in patients with acute osteoporotic vertebral compression fracture (OVCF) undergoing percutaneous vertebroplasty (PVP; n = 58), percutaneous kyphoplasty (PKP; n = 55), or conservative medical therapy (CMT; n = 55). After surgery, Cobb angle and vertebral height were significantly improved in the PKP group. PVP and PKP patients had significantly less pain immediately after surgery than CMT patients, but this difference disappeared between weeks 2-8, only to return from months 6-12.

Comparison of 5766 vertebral compression fractures treated with or without kyphoplasty.

Background: The majority of the 700,000 osteoporotic vertebral compression fractures (VCFs) that occur annually in the United States affect women. The total treatment costs exceed $17 billion and approximate the total costs of breast cancer ($13 billion) and heart disease ($19 billion). Balloon-assisted percutaneous vertebral augmentation with bone cement (kyphoplasty) reportedly reduces VCF-related pain and accelerates return of independent functional mobility.

[Treatment of osteoporotic fractures. A new approach by vertebroplasty and kyphoplasty].

Osteoporosis is a systemic disease and results in progressive bone mineral loss and concurrent change in bone architecture that leave bone vulnerable to fracture. In one third of patients with acute vertebral fracture, severe pain and limited mobility persist despite appropriate nonoperative management. Vertebroplasty is a minimally invasive method that involved the percutaneous injection of cement into a collapsed vertebral body to stabilize the fractured vertebra.

Supportive care aspects of vertebroplasty and kyphoplasty in patients with cancer.

As cancer survival rates continue to improve, many patients with cancer experience an increased incidence of osteolytic bone destruction that can lead to vertebral collapse. Many people with vertebral compression fractures develop pain and spinal deformity, mainly kyphosis. Kyphosis has been associated with a decrease in physical function, depression, loss of independence, decreased lung capacity, malnutrition because of early satiety, and death.

[Results of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures].

The aim of this study was to evaluate the reduction of pain, improvement of sagittal alignment, complications and intermediate term results of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures (VCF). The study group consisted of 87 patients with 145 VCFs which were not responsive to non-operative treatment. All data were collected prospectively.

Nonoperative management of osteoporotic vertebral compression fractures.

As the population ages, vertebral compression fractures are an increasing source of pain and dysfunction. The immobilisation that often occurs with fractures can lead to multiple medical complications and their management can be complex as care may require multiple treatment modalities. Each individual responds to pain differently and a treatment plan must be tailored to the individual's pain, functional limitations and goals.

Effect of kyphoplasty on survival after vertebral compression fractures.

Background: A growing population of patients with osteoporosis and fragility fractures has developed. Fragility fractures, including vertebral compression fractures, have been associated with increased mortality. Early operative interventions for patients sustaining hip fractures have been found to reduce mortality.

Vertebroplasty and kyphoplasty for the management of osteoporotic vertebral compression fractures.

Osteoporotic vertebral compression fractures have previously been treated nonoperatively given the tremendous morbidity associated with open fixation in elderly patients who often have multiple medical comorbidities. With the advent of percutaneous vertebral augmentation techniques, these fractures can now be stabilized using minimally invasive surgical techniques while maintaining a relatively safe risk profile. Vertebroplasty and kyphoplasty provide immediate pain relief in the great majority of patients who have painful, osteoporotic vertebral compression fractures.

Osteoporotic vertebral compression fractures: a review of current surgical management techniques.

Of the estimated 1.5 million osteoporosis-related fragility fractures that occur each year in the United States, vertebral compression fractures (VCFs) are the most common. It is estimated that approximately 20% to 25% of people who sustain a VCF have symptoms severe enough to seek medical attention.

Three-level bilateral pediculolysis following osteoporotic lumbar compression fracture.

Background Context: Osteoporotic compression fractures frequently occur at the thoracolumbar junction as a result of anterior column failure. Fractures of the pedicles are much less common and are not known to be associated with a prior compression fracture. Bilateral pedicle fractures over several consecutive lumbar levels in an osteoporotic elderly patient have not been previously reported.

Functional outcomes of kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures.

Introduction: Vertebral body compression fractures secondary to osteoporosis or malignant osteolysis are an increasingly common problem. The primary purpose of our study was to assess functional outcomes of kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures. Our secondary purpose was to compare such functional outcomes in patients with osteoporosis versus multiple myeloma.

Quality of life following vertebroplasty.

Background: Percutaneous vertebroplasty may be indicated when a patient with a painful osteoporotic vertebral compression fracture remains intolerably symptomatic in spite of comprehensive, nonoperative management. Relief of pain and quality of life following percutaneous vertebroplasty, however, remain incompletely defined. We investigated these outcomes with use of a visual analog scale and a validated, osteoporosis-specific health-related quality-of-life instrument.

Kyphoplasty: report of eighty-two thoracolumbar osteoporotic vertebral fractures.

Objectives: Document initial outcomes of balloon kyphoplasty.

Design: Retrospective analysis of the first 52 patients with 82 painful vertebral body compression fractures secondary to osteoporosis treated at our institution.

Setting: Operation on subacute painful fractures with office follow-up.

Percutaneous vertebral augmentation.

Background Context: With the aging of the population, painful osteoporotic compression fractures are becoming more common.

Purpose: To review the physiologic implications of these injuries as well as treatment options and outcomes, especially with reference to newer, percutaneous "augmentation" procedures, that is, vertebroplasty and kyphoplasty.

Study Design/setting: A literature review.

[Extravertebral cement drainage with occlusion of the extradural venous plexus into the vena cava after vertebrobplasty. Case report and review of the literature].

This paper presents the case report of an 88 year old female who came to hospital suffering from a severe lower back pain. Ten days before, she had undergone a vertebroplasty with injection of cement into lumbar vertebra 3 because of an osteoporotic fracture. This treatment did not result in a reduction of the lower back pain, which was the main reason for the procedure.

Osteoporotic vertebral burst fractures with neurologic compromise.

A retrospective study was performed on the operative results following osteoporotic burst fractures with neurologic compromise. We sought to investigate the results of operative decompression and stabilization in patients with neurologic deficit as a result of an osteoporotic burst fractures. We examined the postoperative radiographic outcomes, level of disability, functional outcomes, and complications.

Humeral shaft nonunions treated with fibular allograft and compression plating.

The present study is a retrospective review of the treatment of 12 humeral shaft nonunions by using an intramedullary allograft with compression plating. The average age of the patients was 61 years (range, 36-82 years). Eight cases involved the proximal shaft, 3 cases were at the mid-diaphyseal level, and 1 case was at the distal one third.