ECTS2013 Workshops Vertebral fractures (3 abstracts)
Lisbon, Portugal.
Vertebral fractures are an important cause of pain and disability in osteoporotic patients.
The main goals of treatment of vertebral fractures are to alleviate pain, stabilize the fracture, prevent new fractures and reduce comorbidities.
Although vertebral fractures are frequently asymptomatic most patients will require analgesic medication for acute pain related with vertebral compression or chronic pain due to kyphosis and posture related problems. Spinal bracing is helpful in reducing pain and stabilizing the fracture during the weeks following an acute vertebral compression. In patients with persistent pain vertebroplasty or kyphoplasty may be indicated and has shown good results in pain control and mobility and function improvement.
Pharmacologic treatment to prevent new fractures is mandatory in patients with vertebral fractures. Available options include antiresorptive (bisphosphonates, SERMs, strontium ranelate, calcitonin, estrogens and denosumab) and anabolic agents (teriparatide). All these options have shown to reduce incidence of new vertebral fractures and choice of agent will depend on osteoporosis severity (several vertebral fractures, high fracture risk), drug availability, comorbidities, cost and patient preference.