Joaquim Andrei F, Bigdon Sebastian F, Bransford Richard, Chhabra Harvinder Singh, Yurac Ratko, Kumar Vishal, El-Sharkawi Mohammad, Benneker Lorin M, Karamian Brian A, Canseco Jose A, Scherer Julian, Hassan Ahmed Abdelazim, Schroeder Gregory D, Öner Cumhur F, Rajasekaran Shanmuganathan, Vialle Emiliano, Kanna Rishi M, Vaccaro Alexander R, Tee Jin, Camino-Willhuber Gaston, Fisher Charles G, Dvorak Marcel F, Schnake Klaus J
Neurosurgery Division, Department of Neurology, State University of Campinas, Campinas-Sao Paulo, Brazil.
Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Global Spine J. 2024 Nov;14(8):2216-2224. doi: 10.1177/21925682241278953. Epub 2024 Aug 24.
Literature review with clinical recommendations.
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.
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.
4 studies were selected. Article 1: a validation of the Osteoporotic Fracture (OF)-score to treat OF fractures. 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. 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. recommendation to prescribe a spinal orthosis to decrease pain and improve quality of life. Article 4: post-traumatic deformity after OF. A recommendation that middle column injury and pre-injury use of steroids may lead to high risk of post-traumatic deformity after OF.
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.
带有临床建议的文献综述。
突出关于骨质疏松性脊柱骨折(OF)的重要研究,这些研究基于AO脊柱KF创伤与感染组关键意见领袖的评估,可能被纳入临床实践。
选取4项可能影响脊柱外科医生当前临床实践的关于OF的重要研究并进行综述,目的是提供临床建议,以简化从研究到临床实践的过程。根据GRADE方法,建议分为强烈或有条件。
选取了4项研究。文章1:骨质疏松性骨折(OF)评分在治疗OF骨折中的验证。建议在骨折管理中纳入OF评分以改善临床结果。文章2:一项随机多中心研究,比较罗莫单抗/阿仑膦酸钠与阿仑膦酸钠降低新椎体骨折发生率的效果。建议与仅使用阿仑膦酸钠的组相比,接受罗莫单抗/阿仑膦酸钠的组发生新OF的风险降低。文章3:脊柱矫形器在管理中的系统文献综述。建议开具脊柱矫形器以减轻疼痛并改善生活质量。文章4:OF后的创伤后畸形。建议中柱损伤和伤前使用类固醇可能导致OF后创伤后畸形的高风险。
OF患者的管理仍然复杂且具有挑战性。本综述提供了一些建议,可能有助于外科医生更好地管理这些患者并改善他们的临床实践。