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Joaquim AF, Bigdon SF, Bransford R, Chhabra HS, Yurac R, Kumar V, El-Sharkawi M, Benneker LM, Karamian BA, Canseco JA, Scherer J, Hassan AA, Schroeder GD, Öner CF, Rajasekaran S, Vialle E, Kanna RM, Vaccaro AR, Tee J, Camino-Willhuber G, Fisher CG, Dvorak MF, Schnake KJ. Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Optimizing Management and Minimizing Risk of Osteoporotic Vertebral Fractures - Perspectives of the AO Spine KF Trauma and Infection Group Key Opinion Leaders. Global Spine J 2024:21925682241278953. [PMID: 39180743 DOI: 10.1177/21925682241278953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2024] Open
Abstract
STUDY DESIGN Literature review with clinical recommendations. OBJECTIVE To highlight important studies about osteoporotic spinal fractures (OF) that may be integrated into clinical practice based on the assessment of the AO Spine KF Trauma and Infection group key opinion leaders. METHODS 4 important studies about OF that may affect current clinical practice of spinal surgeons were selected and reviewed with the aim of providing clinical recommendations to streamline the journey of research into clinical practice. Recommendations were graded as strong or conditional following the GRADE methodology. RESULTS 4 studies were selected. Article 1: a validation of the Osteoporotic Fracture (OF)-score to treat OF fractures. Conditional recommendation to incorporate the OF score in the management of fractures to improve clinical results. Article 2: a randomized multicenter study comparing romosozumab/alendronate vs alendronate to decrease the incidence of new vertebral fractures. Strong recommendation that the group receiving romosozumab/alendronate had a decreased risk of new OF when compared with the alendronate only group only. Article 3: a systematic literature review of spinal orthoses in the management of. Conditional recommendation to prescribe a spinal orthosis to decrease pain and improve quality of life. Article 4: post-traumatic deformity after OF. A conditional recommendation that middle column injury and pre-injury use of steroids may lead to high risk of post-traumatic deformity after OF. CONCLUSIONS Management of patients with OF is still complex and challenging. This review provides some recommendations that may help surgeons to better manage these patients and improve their clinical practice.
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Affiliation(s)
- Andrei F Joaquim
- Neurosurgery Division, Department of Neurology, State University of Campinas, Campinas-Sao Paulo, Brazil
| | - Sebastian F Bigdon
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Richard Bransford
- Harborview Medical Center, University of Washington, Seattle, WA, USA
| | - Harvinder Singh Chhabra
- Department of Spine and Rehabilitation, Sri Balaji Action Medical Institute, New Delhi, India
| | - Ratko Yurac
- Department of Orthopaedic and Traumatology, Clinica Alemana de Santiago, University Del Desarrollo, Vitacura, Chile
| | - Vishal Kumar
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mohammad El-Sharkawi
- Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Lorin M Benneker
- Spine Unit, Sonnenhofspital Bern, University of Bern, Bern, Switzerland
| | | | - Jose A Canseco
- Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Julian Scherer
- Department of Traumatology, University Hospital of Zurich, Zurich, Switzerland
- Orthopaedic Research Unit, University of Cape Town, Cape Town, South Africa
| | - Ahmed Abdelazim Hassan
- Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Assiut University, Assiut, Egypt
- Centre for Spinal Studies and Surgery, Queen`s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Gregory D Schroeder
- Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Cumhur F Öner
- University Medical Centers, Utrecht, The Netherlands
| | | | - Emiliano Vialle
- Cajuru Hospital, Catholic University of Paraná, Curitiba, Brazil
| | - Rishi M Kanna
- Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals, Coimbatore, India
| | - Alexander R Vaccaro
- Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Jin Tee
- The Alfred Hospital, Melbourne, VIC, Australia
| | | | - Charles G Fisher
- Division of Spine Surgery, University of British Columbia and Vancouver General Hospital, Vancouver, BC, Canada
| | - Marcel F Dvorak
- Combined Neurosurgical and Orthopaedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Klaus J Schnake
- Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien Erlangen, Erlangen, Germany
- Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany
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Kweh BTS, Gonzalvo A, Khoo B, Tee JW. In defence of the efficacy and safety of braces in osteoporotic vertebral fractures. JOURNAL OF SPINE SURGERY (HONG KONG) 2023; 9:506-508. [PMID: 38196729 PMCID: PMC10772664 DOI: 10.21037/jss-23-114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/23/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Barry Ting Sheen Kweh
- Department of Neurosurgery, Austin Hospital, Heidelberg, Victoria, Australia
- National Trauma Research Institute, Melbourne, Victoria, Australia
| | - Augusto Gonzalvo
- Department of Neurosurgery, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Boyuan Khoo
- Department of Neurosurgery, Austin Hospital, Heidelberg, Victoria, Australia
| | - Jin Wee Tee
- National Trauma Research Institute, Melbourne, Victoria, Australia
- Department of Neurosurgery, Alfred Hospital, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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