New Osteoporosis Fracture Treatment Program Improves Outcomes for Patients;
Study Finds Cement Procedure Safe and Effective

December 9, 2004
Released: U.S. Newswire

ROSEMONT, Ill. — A recent study confirms that
vertebroplasty offers a safe and effective alternative for patients with painful spine fractures, as featured in the Dec. 2004 issue of The Journal of Bone & Joint Surgery. Percutaneous vertebroplasty involves injecting medical- grade cement into a fractured spinal bone, to stabilize the fracture and reduce the patient's pain.

In this study, researchers compared 46 patients, with an average age of 74, before and after undergoing this fracture- stabilizing technique that requires some anesthesia. This is the first study to use an osteoporosis-specific instrument — the Osteoporosis Quality of Life Questionnaire (OQLQ) — to measure quality of life and pain following vertebroplasty. Osteoporosis is a widespread disease characterized by weak and thinning bones, which leads to increased fractures typically of the hip, spine and wrist. One in two women and one in five men will have an osteoporosis-related fracture in their lifetime. Because bones become thin and brittle, recovering from these fractures can be a long and complex process.

"The OQLQ is specifically designed to gauge quality of life in osteoporotic women with back pain due to a spinal bone fracture," says Fergus McKiernan, MD, one of the study's authors and director of the Center for Bone Diseases at the Marshfield Clinic in Marshfield, Wisc. "We also conducted a comprehensive demographic profile on our patients that included other relevant factors such as their age, smoking history, previous or current steroid use, and bone mineral density."

The researchers found that percutaneous vertebroplasty is safe, and often provides rapid and profound pain relief and improvement in the quality of life for patients. These improvements are maintained for at least six months.

The procedure is most effective when used in conjunction with a comprehensive osteoporosis management program, the researchers suggest. People who have experienced a vertebral compression fracture are five times more likely than other osteoporosis patients to suffer a subsequent fracture within a year. Previous researchers have expressed concern that vertebroplasty might further increase this risk, particularly in spine bones adjacent to the treated level. However, this study found no increase in the occurrence of additional fractures — supporting the recommendation that comprehensive osteoporosis management programs such as this are important in the overall prevention of future fractures.

"In all too many cases, the compression fracture is treated with vertebroplasty and the surgeon does not address the patient's underlying osteoporosis," says Tom Faciszewski, MD, co- author of the study and an orthopaedic surgeon in the Department of Orthopedic Spine Surgery at the Marshfield Clinic. "When the fracture is due to osteoporosis, it's more complicated-the fracture is a sign of a larger illness. Addressing the patient's metabolic bone disease at the same time as the fracture allows us to not only treat the fracture more effectively, but also help prevent subsequent fractures. The surgeon should not be the sole treatment provider — we need to take a team approach to care for these patients."

Drs. Faciszewski and McKiernan both say that they hope their findings will convince surgeons performing vertebroplasty and patients of the value of performing percutaneous vertebroplasty in the context of a comprehensive osteoporosis treatment program.

"If you have an osteoporotic fracture and only the fracture is treated, then the whole problem hasn't been addressed," says Dr. Faciszewski. "They need to reassess bone density, evaluate drug therapy, provide physical therapy and review your other medical conditions."

"Many surgeons are performing this procedure in isolation," says Dr. McKiernan. "But if they do that, they may not be able to achieve the same results that we're showing in this study. I'm hoping that this study helps deliver the message that this procedure can be safe and effective when performed by experts and paired with a comprehensive osteoporosis care program."

The Journal of Bone & Joint Surgery (JBJS) is the official scientific publication of the 27,000-member American Academy of Orthopaedic Surgeons (link 1) (link 2), a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public.

The peer-reviewed JBJS, located in Needham, Mass., is published monthly. Abstracts are available online at www.jbjs.org.

An orthopaedic surgeon is a physician with extensive training in the diagnosis and nonsurgical as well as surgical treatment of the musculoskeletal system including bones, joints, ligaments, tendons and nerves.

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Contact: Carlye Fallon, 847-384-4035, or Teena Austin, both of the American Academy of Orthopaedic Surgeons.