Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, United States.
Global Spine J. 2016 Sep;6(6):524-8. doi: 10.1055/s-0035-1569057. Epub 2015 Nov 26.
Retrospective chart review.
To evaluate the referral rate for long-term osteoporosis management following vertebral compression fracture treated by different specialties at a single academic institution.
Patients undergoing vertebral cement augmentation for painful osteoporotic compression fractures from 2009 to 2014 were identified. Medical records were reviewed to determine if the treating surgeon discussed and/or referred the patient for long-term osteoporosis management. Any referral for or mention of medical long-term osteoporosis management was counted as a positive response. Results were statistically analyzed with chi-square test.
Two hundred fourteen patients underwent vertebral cement augmentation; 150 met inclusion criteria. Orthopedic surgeons treated 88 patients, neurosurgeons treated 39, and interventional radiology or pain management physicians treated 23. Orthopedic surgeons referred 82% of patients for osteoporosis management, neurosurgeons referred 36%, and interventional radiology/pain management referred 17%. The referral rate was significantly higher for orthopedic surgeons compared with either of the other two groups; there was no significant difference between neurosurgery and interventional radiology/pain management.
Among physicians who treat osteoporotic vertebral compression fractures, orthopedic surgeons more frequently address osteoporosis or refer patients for osteoporosis management compared with neurosurgeons and interventional radiologists or pain management physicians. The results of this study shed light on the disparity in how different specialties approach treatment of osteoporosis in patients with fractures painful enough to require surgery and highlight potential areas for improvement in osteoporosis awareness training.
回顾性图表审查。
评估在单一学术机构中，不同专业治疗椎体压缩性骨折后，长期骨质疏松症管理的转诊率。
确定 2009 年至 2014 年间因疼痛性骨质疏松性压缩性骨折接受椎体水泥增强治疗的患者。审查病历以确定治疗外科医生是否讨论过并/或转介患者进行长期骨质疏松症管理。任何关于长期骨质疏松症管理的转介或提及都被视为阳性反应。使用卡方检验对结果进行统计学分析。
214 例患者接受了椎体水泥增强治疗；150 例符合纳入标准。骨科医生治疗了 88 例患者，神经外科医生治疗了 39 例，介入放射科或疼痛管理医生治疗了 23 例。骨科医生转诊 82%的患者进行骨质疏松症管理，神经外科医生转诊 36%，介入放射科/疼痛管理转诊 17%。与其他两组相比，骨科医生的转诊率明显更高；神经外科与介入放射科/疼痛管理之间无显著差异。
在治疗骨质疏松性椎体压缩性骨折的医生中，与神经外科医生和介入放射科医生或疼痛管理医生相比，骨科医生更频繁地涉及骨质疏松症或转介患者进行骨质疏松症管理。本研究的结果揭示了不同专业在治疗骨折疼痛足以需要手术的患者的骨质疏松症方面的差异，并强调了在骨质疏松症意识培训方面需要改进的潜在领域。
