[article] 
inActa Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.444-450

Titre :	Non-Union Of Osteoporotic Vertebral Fractures – Identification And Treatment Of An Underestimated Pathology In Elderly Patients With Persistent Back Pain
Type de document :	texte imprimé
Auteurs :	Daniel ADLER, Auteur
Année de publication :	2014
Article en page(s) :	p.444-450
Langues :	Anglais (eng)
Mots-clés :	persistent back pain  osteoporosis  vertebral non-union  kyphoplasty  spine surgery
Résumé :	Objective : Non-union of osteoporotic vertebra fractures are a seldom entity. However, when back pain persists in the course of conservatively treated osteoporotic vertebra fractures, a non-union should be considered. We thus sought to validate our diagnostic algorithm in patients with known osteoporotic vertebra fractures presenting persistent back pain and advert to the diagnosis and treatment of vertebral non-unions. Patients and Methods : Patients admitted with preexisting osteoporotic vertebra fractures and therapyresistant back pain were retrospectively analysed. All admitted patients were subject to standard plain radiographs in erect position and conventional CT or MR imaging of the spine, respectively. In addition, patients with suspected non-union were subject to lateral fulcrum radiographs in supine position. Results : From a total of 172 admitted patients, four patients presented with non-union of a fractured osteoporotic vertebra (2%). The subsequent surgical therapy included cement-augmented rod-and-screw stabilization, with or without additional correction of deformity, and kyphoplasty (N = 3) or kyphoplasty alone (N = 1). All surgical interventions were successful in pain reduction and allowed immediate and improved postoperative mobilisation. Conclusions : Non-union of osteoporotic vertebra fractures must be considered when symptoms outlast conservative treatment. In these cases, plain lateral fulcrum radiographs are a simple and effective adjunct to the conventional diagnostic methods. Surgical stabilization then proves to be the effective treatment of choice.
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[article] Non-Union Of Osteoporotic Vertebral Fractures – Identification And Treatment Of An Underestimated Pathology In Elderly Patients With Persistent Back Pain [texte imprimé] / Daniel ADLER, Auteur . - 2014 . - p.444-450.
Langues : Anglais (eng)
in Acta Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.444-450

Mots-clés :	persistent back pain  osteoporosis  vertebral non-union  kyphoplasty  spine surgery
Résumé :	Objective : Non-union of osteoporotic vertebra fractures are a seldom entity. However, when back pain persists in the course of conservatively treated osteoporotic vertebra fractures, a non-union should be considered. We thus sought to validate our diagnostic algorithm in patients with known osteoporotic vertebra fractures presenting persistent back pain and advert to the diagnosis and treatment of vertebral non-unions. Patients and Methods : Patients admitted with preexisting osteoporotic vertebra fractures and therapyresistant back pain were retrospectively analysed. All admitted patients were subject to standard plain radiographs in erect position and conventional CT or MR imaging of the spine, respectively. In addition, patients with suspected non-union were subject to lateral fulcrum radiographs in supine position. Results : From a total of 172 admitted patients, four patients presented with non-union of a fractured osteoporotic vertebra (2%). The subsequent surgical therapy included cement-augmented rod-and-screw stabilization, with or without additional correction of deformity, and kyphoplasty (N = 3) or kyphoplasty alone (N = 1). All surgical interventions were successful in pain reduction and allowed immediate and improved postoperative mobilisation. Conclusions : Non-union of osteoporotic vertebra fractures must be considered when symptoms outlast conservative treatment. In these cases, plain lateral fulcrum radiographs are a simple and effective adjunct to the conventional diagnostic methods. Surgical stabilization then proves to be the effective treatment of choice.
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