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Abstract
Objectives
To present updated information on the conservative treatment of osteoporotic spinal fractures (OSFs).
Summary of Literature Review
The treatments of osteoporotic spinal fractures are bed rest, pain medication, bracing, exercise and rehabilitation, and osteoporosis medication. However, there is disagreement about the outcomes of these treatments.
Results
In the case of osteoporotic spinal fractures, analgesic administration, bracing, physical therapy, and exercise should be conducted. In order to prevent secondary fractures, bisphosphonates, selective estrogen receptor modulators, strontium ranelate, or parathyroid hormone, which has proven efficacy with respect to the prevention of secondary fractures, should be prescribed.
REFERENCES
1. Robin H, Juliet M. A new system for grading recommen-dations in evidence based guidelines. BMJ. 2001; 323:334–6.
2. Gerdhem P. Osteoporosis and fragility fractures: Vertebral fractures. Best Pract Res Clin Rheumatol. 2013; 7:743–55.
3. Cherubiono P, Sarzi-Puttini P, Zuccaro SM, et al. The management of chronic pain in important patient sub-groups. Clin Drug Investig. 2012; 32:35–44.
4. Cherasse A, Muller G, Ornetti P, et al. Tolerability of opioids in patients with acute pain due to nonmalignant musculo-skeletal disease. A hospital-based observational study. Joint Bone Spine. 2004; 71:572–6.
5. Longo UG, Loppini M, Denaro L, et al. Osteoporotic vertebral fractures: current concepts of conservative care. Br Med bull. 2012; 102:171–89.
6. van Tulder MW, Touray T, Furlan AD, et al. Muscle relax-ants for non-specific low back pain. Cochrane Database Syst Rev. 2003; 2:CD004252.
7. Cauley JA, Black D, Boonen S, et al. Once-yearly zole-dronic acid and days of disability, bed rest, and back pain: randomized, controlled HORIZON Pivotal Fracture Trial. J Bone Miner Res. 2011; 26:984–92.
8. Rovetta G, Maggiani G, Molfetta L, et al. One-month followup of patients treated by intravenous clodronate for acute pain induced by osteoporotic vertebral fracture. Drugs Exp Clin Res. 2001; 27:77–81.
9. Rovetta G, Monteforte P, Balestra V. Intravenous clodronate for acute pain induced by osteoporotic vertebral fracture. Drugs Exp Clin Res. 2000; 26:25–30.
10. Armingeat T, Brondino R, Pham T, et al. Intravenous pamidronate for pain relief in recent osteoporotic vertebral compression fracture: a randomized double-blind controlled study. Osteoporos Int. 2006; 17:1659–65.
11. Black DM, Cummings SR, Karpf DB, et al. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet. 1996; 348:1535–41.
12. Wells GA, Cranney A, Peterson J, et al. Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev. 2008; 1:CD001155.
13. Reginster J, Minne HW, Sorensen OH, et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int. 2000; 11:83–91.
14. Wells G, Cranney A, Peterson J, et al. Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev. 2008; 1:CD004523.
15. Delmas PD, Recker RR, Chesnut CH 3rd, et al. Daily and intermittent oral ibandronate normalize bone turnover and provide significant reduction in vertebral fracture risk: results from the BONE study. Osteoporos Int. 2004; 15:792–8.
16. Chesnut CH 3rd, Skag A, Christiansen C, et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004; 19:1241–9.
17. Ettinger B, Black DM, Mitlak BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999; 282:637–45.
18. Silverman SL, Christiansen C, Genant HK, et al. Efficacy of bazedoxifene in reducing new vertebral fracture risk in postmenopausal women with osteoporosis: results from a 3-year, randomized, placebo-, and active-controlled clinical trial. J Bone Miner Res. 2008; 23:1923–34.
19. Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004; 350:459–68.
20. Chesnut CH 3rd, Silverman S, Andriano K, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study Group. Am J Med. 2000; 109:267–76.
21. Neer RM, Arnaud CD, Zanchetta JR, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001; 344:1434–41.
22. Cheng MH, Chen JF, Fuh JL, et al. Osteoporosis treatment in postmenopausal women with preexisting fracture. Tai-wan J Obstet Gynecol. 2012; 51:153–66.
23. Eastell R, Nickelsen T, Marin F, et al. Sequential treatment of severe postmenopausal osteoporosis after teriparatide: final results of the randomized, controlled European Study of Forsteo (EUROFORS). J Bone Miner Res. 2009; 24:726–36.
24. Kim HJ, Yi JM, Cho HG, et al. Comparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace: a prospective randomized controlled non-inferiority trial. J Bone Joint Surg Am. 2014; 96:1959–66.
25. Rzewuska M, Ferreira M, McLachlan AJ, et al. The efficacy of conservative treatment of osteoporotic compression fractures on acute pain relief: a systematic review with meta-analysis. Eur Spine J. 2015; 24:702–14.
26. Howe TE, Howe TE, Rochester L, et al. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011; 11:CD000333.
27. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the com-munity. Cochrane Database Syst Rev. 2012; 9:CD007146.
28. Giangregorio LM, Macintyre NJ, Thabane L, et al. Exercise for improving outcomes after osteoporotic vertebral fracture. Cochrane Database Syst Rev. 2013; 1:CD008618.
29. Bergland A, Thorsen H, Kå resen R. Effect of exercise on mobility, balance, and health-related quality of life in osteoporotic women with a history of vertebral fracture: a randomized, controlled trial. Osteoporos Int. 2011; 22:1863–71.
30. Gold DT, Shipp KM, Pieper CF, et al. Group treatment improves trunk strength and psychological status in older women with vertebral fractures: results of a randomized, clinical trial. J Am Geriatr Soc. 2004; 52:1471–8.
31. Papaioannou A, Adachi JD, Winegard K, et al. Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int. 2003; 14:677–82.
32. Bennell KL, Matthews B, Greig A, et al. Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pi-lot trial. BMC Musculoskelet Disord. 2010; 11:36. Available from:. http://www.biomedcentral.com/1471-2474/11/36.
Table 1.
Levels of Evidence.
Table 2.
Grades of Recommendations.
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