A systematic review of the Irish osteoporotic vertebral fracture literature

McCabe, Eva; Ibrahim, Ammar; Singh, Rajneet; Kelly, Michael A.; Armstrong, Catherine; Heaney, Fiona; Bergin, Diane; McCabe, John P.; Carey, John J.

doi:10.1007/s11657-020-0704-0

Cited by 7 publications

(8 citation statements)

References 32 publications

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“…This is in line with others [17], and a well described epidemiologic phenomenon [44]. Although some believe fractures in people whose BMD is not below the fracture threshold do not need treatment, a diagnosis of osteoporosis can be made and treatment offered in the presence of a major osteoporotic fracture and the absence of major trauma or other explanations [14,32,45]. Others have shown the risk of subsequent fracture is significantly higher in patients with low BMD and prevalent fractures than those with low BMD alone [30,31].…”

Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

“…Recent publications on the prevalence, incidence and impact of VF in Ireland highlight a paucity of studies [29,32]. Reasons include under-representation, under-diagnosis and limited data from non-hospital settings [29,[32][33][34]. Reports suggest hospital length of stay is similar to hip fractures [33], while others show VF are common when imaging studies are systematically evaluated [29,34].…”

Section: Introductionmentioning

confidence: 99%

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Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

et al. 2021

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Osteoporosis is an important global health problem resulting in fragility fractures. The vertebrae are the commonest site of fracture resulting in extreme illness burden, and having the highest associated mortality. International studies show that vertebral fractures (VF) increase in prevalence with age, similarly in men and women, but differ across different regions of the world. Ireland has one of the highest rates of hip fracture in the world but data on vertebral fractures are limited. In this study we examined the prevalence of VF and associated major risk factors, using a sample of subjects who underwent vertebral fracture assessment (VFA) performed on 2 dual-energy X-ray absorptiometry (DXA) machines. A total of 1296 subjects aged 40 years and older had a valid VFA report and DXA information available, including 254 men and 1042 women. Subjects had a mean age of 70 years, 805 (62%) had prior fractures, mean spine T-score was − 1.4 and mean total hip T-scores was − 1.2, while mean FRAX scores were 15.4% and 4.8% for major osteoporotic fracture and hip fracture, respectively. Although 95 (7%) had a known VF prior to scanning, 283 (22%) patients had at least 1 VF on their scan: 161 had 1, 61 had 2, and 61 had 3 or more. The prevalence of VF increased with age from 11.5% in those aged 40–49 years to > 33% among those aged ≥ 80 years. Both men and women with VF had significantly lower BMD at each measured site, and significantly higher FRAX scores, P < 0.01. These data suggest VF are common in high risk populations, particularly older men and women with low BMD, previous fractures, and at high risk of fracture. Urgent attention is needed to examine effective ways to identify those at risk and to reduce the burden of VF.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

et al. 2021

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Section: Discussionmentioning

confidence: 99%

“…The prevalence of VFs within Ireland was recently studied in a systematic review that highlighted that the true prevalence was difficult to ascertain due to definitions used and differences in the study populations [20]. McCabe et al noted a VF prevalence ranging 5% among hospitalised population to 90% in older individuals with low bone density in whom a fracture was suspected [20]. Two prior studies from Belfast showed a prevalence of VF ranging from 2.7% in a fracture liaison service setting ranging up to 40.7% a cross-sectional study of a group of Northern Ireland men with low-trauma forearm fractures [21,22].…”

Section: Discussionmentioning

confidence: 99%

Detection of vertebral fracture in an acute hospital setting: an intervention to reduce future fracture risk through fracture liaison service intervention?

Toal¹,

McLoughlin²,

Pierce³

et al. 2020

Arch Osteoporos

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Summary We introduced a standardised reporting system in the radiology department to highlight vertebral fractures and to signpost fracture prevention services. Our quality improvement project achieved improved fracture reporting, access to the FLS service, bone density assessment and anti-fracture treatment. Purpose Identification of vertebral fragility fractures (VF) provides an opportunity to identify individuals at high risk who might benefit from secondary fracture prevention. We sought to standardise VF reporting and to signpost fracture prevention services. Our aim was to improve rates of VF detection and access to our fracture liaison service (FLS). Methods We introduced a standardised reporting tool within the radiology department to flag VFs with signposting for referral for bone densitometry (DXA) and osteoporosis assessment in line with Royal Osteoporosis Society guidelines. We monitored uptake of VF reporting during a quality improvement phase and case identification within the FLS service. Results Recruitment of individuals with VF to the FLS service increased from a baseline of 63 cases in 2017 (6%) to 95 (8%) in 2018 and 157 (8%) in 2019 and to 102 (12%) in the first 6 months of 2020 (p = 0.001). One hundred fifty-three patients with VFs were identified during the QI period (56 males; 97 females). Use of the terminology ‘fracture’ increased to 100% (mean age 70 years; SD 13) in computed tomography (n = 110), plain X-ray (n = 37) or magnetic resonance imaging (n = 6) reports within the cohort. Signposting to DXA and osteoporosis assessment was included in all reports (100%). DXA was arranged for 103/153; 12 failed to attend. Diagnostic categories were osteoporosis (31%), osteopenia (36%) or normal bone density (33%). A new prescription for bone protection therapy was issued in 63/153. Twelve of the series died during follow-up. Conclusions Standardisation of radiology reporting systems facilitates reporting of prevalent vertebral fractures and supports secondary fracture prevention strategies.

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Virtual rehabilitation for patients with osteoporosis or other musculoskeletal disorders: a systematic review

Thuilier,

Carey,

Dempsey

et al. 2024

Virtual Reality

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This study aims to identify effective ways to design virtual rehabilitation to obtain physical improvement (e.g. balance and gait) and support engagement (i.e. motivation) for people with osteoporosis or other musculoskeletal disorders. Osteoporosis is a systemic skeletal disorder and is among the most prevalent diseases globally, affecting 0.5 billion adults. Despite the fact that the number of people with osteoporosis is similar to, or greater than those diagnosed with cardiovascular disease and dementia, osteoporosis does not receive the same recognition. Worldwide, osteoporosis causes 8.9 million fractures annually; it is associated with substantial pain, suffering, disability and increased mortality. The importance of physical therapy as a rehabilitation strategy to avoid osteoporosis fracture cannot be over-emphasised. However, the main rehabilitation challenges relate to engagement and participation. The use of virtual rehabilitation to address such challenges in the delivery of physical improvement is gaining in popularity. As there currently is a paucity of literature applying virtual rehabilitation to patients with osteoporosis, the authors broadened the search parameters to include articles relating to the virtual rehabilitation of other skeletal disorders (e.g. Ankylosing spondylitis, spinal cord injury, motor rehabilitation, etc.). This systematic review initially identified 130 titles, from which 23 articles (involving 539 participants) met all eligibility and selection criteria. Four groups of devices supporting virtual rehabilitation were identified: a head-mounted display, a balance board, a camera and more specific devices. Each device supported physical improvement (i.e. balance, muscle strength and gait) post-training. This review has shown that: (a) each device allowed improvement with different degrees of immersion, (b) the technology choice is dependent on the care need and (c) virtual rehabilitation can be equivalent to and enhance conventional therapy and potentially increase the patient’s engagement with physical therapy.

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A systematic review of the Irish osteoporotic vertebral fracture literature

Cited by 7 publications

References 32 publications

Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

Detection of vertebral fracture in an acute hospital setting: an intervention to reduce future fracture risk through fracture liaison service intervention?

Virtual rehabilitation for patients with osteoporosis or other musculoskeletal disorders: a systematic review

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