The effects of person-centered or other supportive interventions in older women with osteoporotic vertebral compression fractures—a systematic review of the literature

Abstract

Vertebral compression fracture (VCF) is a common fragility fracture and the starting point of a lasting, painful, disabling condition. The aim was to summarize evidence of person-centered/non-medical interventions supporting women with VCF. Results show small numbers of studies with only probable effect on function, pain, QoL, fear of falling, and psychological symptoms. The vertebral compression fracture (VCF) caused by osteoporosis is the third most common fragility fracture worldwide. Previously, it was believed that the pain caused by VCF was self-subsiding within weeks or a few months post-fracture. However, this positive prognosis has been refuted by studies showing that, for the great majority of patients, the VCF was the starting point of a long-lasting, severely painful, and disabling condition. The low number of studies focusing on the experience of the natural course of VCF, and what support is available and how it is perceived by those affected, calls for further investigation. Strengthening older patients’ sense of security and increasing confidence in their own abilities are of great importance for successful rehabilitation following VCF. More research is needed to identify resources, possibilities, and strategies that can assist older patients to reach their goals to improve well-being. The purpose of this systematic review was to identify and summarize the current evidence of person-centered or other structured non-medical/non-surgical interventions supporting older women after experiencing an osteoporotic VCF. A systematic literature search was conducted on the MeSH terms encompassing osteoporosis and vertebral compression fractures in the PubMed-MEDLINE and Cumulative Index for Nursing and Allied Health Literature (CINAHL) databases during March through June 2015. The initial search identified 8789 articles, but only seven articles (six randomized controlled trials and one observational study with a control group) met the inclusion criteria. It became evident from the current study that the availability of evidence on the effects of non-medical interventions aiming to support older women with VCF is limited, to say the least. The trials included in this review have few limitations and were mainly considered to be of moderate quality. This systematic literature review suggests that non-medical interventions aiming to support older women with VCF might decrease levels of pain and use of analgesic as well as promote improved physical mobility and function. These interventions would probably result in an improved difference in experiences of fear of falling and perceived psychological symptoms, but would only slightly improve quality of life. However, given the nature of the seven studies, potential biases in patient selection, issues around precision with small cohorts, and failure to control for confounders, makes it difficult to draw a definitive conclusion about the significant effects of non-medical interventions. Incurring a VCF is a complex and diverse event, necessitating equally complex int...

Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures

“…Osteoporotic vertebral compression fractures (OVCFs) mainly cause sudden severe pain, progressive kyphosis, decreased quality of life, and increased mortality [ 1 – 3 ]. Although patients with milder conditions may be treated with bed rest and non-steroidal anti-inflammatory drugs, many patients cannot receive non-surgical treatment due to additional health problems caused by immobilization [ 4 ].…”

Comparison of morbidity and mortality of hip and vertebral fragility fractures: Which one has the highest burden?

“…This significantly increased morbidity could be related to the vertebral fracture itself, associated with severe back pain, aggravated spinal deformity, decreased mobility, and decreased pulmonary function through pulmonary restrictive syndrome, leading to severe restriction of independence and sometimes to institutionalization [ 12 , 33 , 41 ]. Moreover, exaggerated kyphosis associated with vertebral fractures may lead also to spinal stenosis, fatigue, early satiety and weight loss, and inactivity, leading to a higher risk of deep vein thrombosis and low self-esteem with significant emotional and social problems [ 12 , 42 , 43 ]. All of these factors may account for the significantly increased morbidity associated with vertebral fractures.…”

Perioperative Hidden Blood Loss in Elderly Osteoporotic Vertebral Compression Fracture Patients With Percutaneous Vertebroplasty and Influencing Factors

“…According to the patients’ sex, height, weight and other data, their blood volume was calculated using the method reported by Nadler et al 13 The formula was as follows: Blood volume = k1 × height (m) 3 + k2 × weight (kg) + k3. For male patients: k1 = 0.3669, k2 = 0.03219 and k3 = 0.6041; for female patients: k1 = 0.3561, k2 = 0.03308 and k3 = 0.1833.…”

“…2 The main symptoms of OVCF are back pain and limited mobility which seriously affect the quality of life and result in a substantial social and economic burden. 3 Older people (>85 years old) have a higher incidence of OVCF, and most of these patients are in poor physical condition, have other chronic diseases, and a poor tolerance of blood loss. Conservative treatment methods such as bed rest can easily lead to a vicious cycle of worsening osteoporosis.…”