Effects of anti-osteoporosis medications on radiological and clinical results after acute osteoporotic spinal fractures: a retrospective analysis of prospectively designed study

Effect of Osteoporosis Medication on Fracture Healing: An Evidence Based Review

“…Tsuchie et al [42] reported less vertebral collapse and kyphotic angle change in TPTD treated group, but Iwata et al [53] found that fracture site stability parameters were not significantly different between the groups. In addition, Min et al [44] reported that change of vertebral body height loss was favorable to TPTD treated patients, but change of local kyphosis and the rate of fracture instability were similar between the groups. For fracture site pain, 2 studies reported significantly less pain in TPTD treated patients at last follow-up, [42,44] 1 study found that TPTD treated patients had less pain, but the findings were not statistically significant, [54] and 1 study reported results according to the pain measurement methods (Tables 6 and 7).…”

“…In 1 retrospective study, vertebral body collapse and local kyphotic angle change were significantly lower in TPTD treated patients with thoracolumbar spine fracture, [42] but those stability parameters were not significantly different between the groups in other 2 recent studies (Tables 4 and 5). [43,44]…”

Comments on Min et al.: Effects of anti-osteoporosis medications on radiological and clinical results after acute osteoporotic spinal fractures: a retrospective analysis of prospectively designed study

“…We read with great interest the article by Min et al [1]. In their study, the authors found that for patients with osteoporotic spinal fractures (OSFs), teriparatide showed better improvements compared with bisphosphonates or non-antiosteoporosis therapy with regard to numerical rating scale, vertebral height loss and incidence of intravertebral cleft (IVC).…”

Early Alendronate Can Be Safe during Fracture Healing?

“…Likewise, patients who started on treatment within 2 years of fracture were excluded from the study. (8) Therefore, based on the available evidence, it would seem prudent to delay antiresorptive therapy with bisphosphonates or at least withhold the current treatment until there is radiographic evidence of fracture healing to avoid reducing bone remodeling and thus conversion of soft callus to solid bone. (4,5) The reasons for starting a bisphosphonate before healing is complete is to prevent early additional fractures, which can occur after a vertebral fracture.…”

“…(6,7) Furthermore, a recent study showed bisphosphonates have little effect on healing new fracture after suffering an acute osteoporotic spine fracture compared with placebo. (8) Therefore, based on the available evidence, it would seem prudent to delay antiresorptive therapy with bisphosphonates or at least withhold the current treatment until there is radiographic evidence of fracture healing to avoid reducing bone remodeling and thus conversion of soft callus to solid bone. (4,5) Because of this, the cover page highlight probably should read "Early Alendronate Can Be Safe During Fracture Healing," as this is the only conclusion supported by evidence in the article.…”