Management of Osteoporosis and Spinal Fractures: Contemporary Guidelines and Evolving Paradigms

Imamudeen, Nasvin; Basheer, Amjad; Iqbal, Anoop Mohamed; Manjila, Mihal; Manjila, Nihal; Haroom, Nisha Nigil; Manjila, Sunil

doi:10.3121/cmr.2021.1612

Cited by 30 publications

(14 citation statements)

References 53 publications

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“…Thus, there is a high probability to misdiagnose a burst fracture in a young patient without a history of chronic illness as traumatic instead of osteoporotic. Prompt identification of osteoporosis by BMD measurements using dual X-ray absorptiometry (DEXA) [ 14 ] is crucial to avoid unexpected sequelae. Additionally, the possibility of adverse postoperative complications, including fracture nonunion, fixation failure, or revision surgery, can be minimized.…”

Section: Discussionmentioning

confidence: 99%

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

Nikolaou,

Chatzikomninos,

Tournis

et al. 2023

Cureus

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Low-impact spinal fractures in young patients are rare and should raise suspicion of an underlying condition, as these injuries are typically the result of high-energy trauma. We describe a case of a young male patient who sustained a burst fracture of the first lumbar vertebra (L1) following low-energy trauma. The patient underwent percutaneous posterior spinal instrumentation, yet the poor bone quality detected intraoperatively prompted further diagnostic evaluation. Subsequently, low bone mineral density (BMD) was detected, and a rare plastine-3 (PLS3) gene mutation was revealed in the genetic analysis. The patient was initiated on teriparatide therapy after the discovery of osteoporosis postoperatively. It is, therefore, imperative to investigate all young patients with low-energy spinal fractures preoperatively to discover the underlying pathology promptly.

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Section: Discussionmentioning

confidence: 99%

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

Nikolaou,

Chatzikomninos,

Tournis

et al. 2023

Cureus

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“…The study group consisted of 373 patients who were assigned a disability group in 2022 and who had the Постановка проблеми. За сучасними науковими уявленнями остеопорозце прогресуюче захворювання скелету, що характеризується низькою кістковою масою та мікроархітектурними порушеннями кісткової тканини з подальшим підвищенням ламкості кісток і схильністю до переломів [1,2]. Поширеність даного стану у світі досягла межі, яка характеризує епідемічний характер патології сьогодні.…”

Section: Secondary Osteoporosis As a Medical And Social Problemunclassified

Вторинний Остеопороз – Як Медико-Соціальна Проблема

Борисова

2024

Перспективи та інновації науки

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following conditions as their main disabling diseases, which, according to the literature, could be pathogenetically accompanied by osteoporosis, in particular, diseases of the musculoskeletal system and chronic inflammatory liver disease. The average age of the subjects was 52.0±4.7 years; 172 (46.1%) of them were women.The results of the study showed that among 373 patients who were assigned a disability group in 2022 in the Dnipro region and who had conditions that could be pathogenetically accompanied by osteoporosis, in particular, diseases of the musculoskeletal system and chronic inflammatory liver disease, the prevalence of osteoporosis was 26.%, osteopenia -14.5%. The study also showed that among 134 patients who were assigned a disability group and underwent densitometry, the prevalence of osteoporotic changes was 98.5%: osteoporosis was detected in 58.2% of cases and osteopenia in 15.7% of cases. Thus, in clinical practice and during medical and social examination to determine the signs of disability, it is necessary to determine polymorbidity to objectify the functional status of patients. It is advisable to determine the mineral density of bone tissue using a dual X-ray densitometer in patients with chronic inflammatory liver disease and/or degenerative diseases of the joints and spine to detect functional changes in the form of osteoporosis and its possible clinical manifestations as additional conditions for the formation of disabilities.

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“…Osteoporotic vertebral fractures (OVFs) resulting from a small trauma frequently, and sometimes spontaneously, occur in elderly patients [ 1 ]. OVFs are characterized by varying degrees of local pain, especially axial back pain, surrounding the fracture position [ 2 ]. Some patients with OVFs in the lower lumbar spine complain of post-traumatic new-onset radiating pain in the lower limbs, which is similar to the symptoms of lumbar disc herniation (LDH) or foraminal/canal stenosis, which is induced by intervertebral foramen encroachment resulting from decreased foraminal height and migrated fractured fragment [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical management of lower limb radiculopathy following acute singe-level osteoporotic vertebral fracture of lower lumbar spine in geriatric patient: a retrospective study

Zhang,

Lu,

Lin

et al. 2024

BMC Musculoskelet Disord

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Background Radiculopathy of the lower limb after acute osteoporotic vertebral fractures (OVFs) in the lower lumbar spine is uncommon in geriatric patients. Moreover, surgical intervention is generally recommended in patients who are irresponsive to conservative treatment. Determining an optimum surgical strategy is challenging considering the poor general condition of this population. Thus, herein, we established an algorithm for surgically managing this clinical scenario, hoping to provide a reference for making a surgical decision. Methods We retrospectively studied patients who suffered from new-onset radiculopathy of the lower limb after acute single-level OVFs in the lower lumbar spine and eventually underwent surgical intervention at our department. Information on the demographics, bone quality, AO spine classification of the vertebral fracture, pre-existing degenerative changes, including foraminal stenosis and lumbar disc herniation, and surgical intervention type was collected. Additionally, clinical outcomes, including preoperative and postoperative visual analog scale (VAS) scores for back and leg pain, Oswestry disability index (ODI), and MacNab criterion for response to surgery, were evaluated. Results From September 2019 to December 2021, a total of 22 patients with a mean age of 68.59 ± 9.74 years were analyzed. The most involved vertebra was L5 (54.5%), followed by L4 (27.3%) and L3 (18.2%). Among the 22 patients, 15 (68.2%) were diagnosed with the A1 type fracture of AO classification, and among them, 11 (73.3%) were characterized by the collapse of the inferior end plate (IEP). Three patients (13.6%) suffered from A2-type fractures, whereas four patients (18.2%) suffered from A3-type fractures. Pre-existing degenerative changes were observed in 12 patients (54.5%) of the patients. A total of 16 patients (72.7%) were treated by percutaneous kyphoplasty (PKP). Additionally, three patients underwent posterior instrumentation and fusion, two patients underwent a secondary endoscopic foraminoplasty, and one patient underwent a secondary radiofrequency ablation. The mean follow-up period was 17.42 ± 9.62 months. The mean VAS scores for leg and back pain and ODI decreased significantly after the surgery (P < 0.05). The total satisfaction rate at the last follow-up was 90.9% per the Macnab criterion. Conclusion Patients with OVFs in the IEP are predisposed to suffer from radiculopathy of the lower limb. PKP alone or in combination with other minimally invasive surgical strategies is safe and effective in treating stable fractures. Additionally, aggressive surgical intervention should be considered in patients with unstable fractures or severe foraminal encroachment.

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Management of Osteoporosis and Spinal Fractures: Contemporary Guidelines and Evolving Paradigms

Cited by 30 publications

References 53 publications

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

Вторинний Остеопороз – Як Медико-Соціальна Проблема

Surgical management of lower limb radiculopathy following acute singe-level osteoporotic vertebral fracture of lower lumbar spine in geriatric patient: a retrospective study

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