2023 Volume 14 Issue 12 Pages 1439-1442
Introduction: Osteoporotic vertebral fractures (OVFs) are often associated with reduced activities of daily living (ADL). At our institute, OVF patients were hospitalized in an instant cast, kept on bed rest, and released from bed at a NRS of 3 or less. Here, we report on the results of this conservative treatment for OVFs.
Methods: A total of 42 patients (18 males and 24 females, mean age 83.0 years) admitted to our hospital with fresh OVF in June 2020 were included in this study. Image findings (X-ray, CT, MR, bone mineral density), the number of total vertebral fractures, duration of bed rest, and ADL before injury and at the last survey were evaluated as the non-union risk or severity of osteoporosis.
Results: CT revealed 8 cases of diffuse idiopathic skeletal hyperostosis, and 4 cases of posterior wall and pedicle fracture. MRI revealed 11 cases of T2 high signal localized sign, and 17 cases of T2 low signal extensive sign. Bone mineral density analysis revealed 15 cases of the lumbar spine and 21 cases of the femur with YAM <70%. The mean number of total vertebral fractures was 2.0, and the mean length of bed rest was 9.0 days. Significant differences were found between patients with and without risk of osteoporosis in terms of the sitting X-ray vertebral collapse rate, MRI signal changes, bone mineral density, and the total number of vertebral fractures. No significant difference was found in the number of patients who showed a decline in ADL to non-independent status at the end of follow-up.
Conclusions: From the perspective of preserving ADL, our conservative treatment of OVF is considered superior, since ADL declined to a non-independent status, even after approximately 9 days of bed rest.
