THE MANAGEMENT OF OSTEOPOROTIC VERTEBRAL FRACTURES AT A DISTRICT GENERAL HOSPITAL

Introduction

1. Most common osteoporotic fracture

2. 20-30% of patients with OVFs are presented to hospital while 2.2 million remain undiagnosed, as diagnosis is usually opportunistic

3. 66,000 OVFs occur annually in the UK with increase by 18,000 cases a year until 2025.

4. 20% chance of another OVF in next 12 months and 3 times risk of hip fracture.

5. Acute painful OVFs poorly tolerated by infirm elderly patients, leading to significant morbidity and 8 times increase in age-adjusted mortality.

Materials and Methods

1. Classify fracture severity and patents with ovfs in 12-month period.

2. To assess follow-up status and if kyphoplasty was offered within 6 weeks as per NICE guidelines.

3. To introduce Royal Osteoporosis Society and GIRFT guidelines on management of symptomatic osteoporotic vertebral fractures

Results

1. Total no. of patients- 62

2. Initial pain assessment=40

3. Pain assessed at ≤6 weeks- 21

4. Duration from decision to operate to kyphoplasty 8.7 weeks.

5. 11% had kyphoplasty of which 50% noted improvement in pain.

6. 11 deaths

7. Nearly similar findings to NoSH study

Conclusion

1. To improve pain assessment on admission of patients with acute osteoporotic vertebral fractures.

2. To follow GIRFT guidelines for early assessment and intervention in patients with acute osteoporotic vertebral fractures to improve pain, mobility and early discharge from hospital.

Conflicts of interest

None

Sources of funding

None