Abstract
Introduction: Spinal fracture of pregnancy and lactation-associated osteoporosis (PLO) is rare, and its incidence is unknown. Experiences and awareness of the spinal fractures with PLO were studied among orthopedic surgeons in Hyogo prefecture.
Methods: A total of 436 members and colleges of the Hyogo Clinical Orthopaedic Association (HCOA) and the chief orthopedic surgeons of 38 hospitals performing delivery in Hyogo prefecture during 2021-22 were interviewed using a questionnaire about their experiences and awareness of spinal fractures with PLO by e-mail, mail, and face-to-face survey. The questionnaire was composed of the same items published elsewhere (Obori et al. JJOS, 2018). The final response rate to the questionnaire was 73% in HCOA members. Studies considering their age and working status (clinic, hospital, academic, and others) were also performed.
Results: The average age of the orthopedic surgeons was 60.1 (37- 85) years. There were 177 clinic doctors with an average age of 60.1 years, 117 hospital doctors with an average age of 59.9 years, 11 academic doctors with an average age of 52.5 years, and 12 doctors working in other fields with an average age of 69.9 years. A total of 32 surgeons (10.1%) saw 49 spinal PLO fractures. Previous experience and the number of cases in different working conditions were 5 cases within a year (clinic: 3 cases, hospital: 2 cases), 11 cases in 2-5 years (clinic: 3, hospital: 8), 18 cases in 6-10 years (clinic: 8, hospital: 7, others: 3), 12 cases in 11-20 years (clinic: 9, hospital: 3), and 3 cases over 21 years (clinic: 1, others: 2). The percentage of the doctors who did not know about PLO disease were 57.6% in the clinic, 59.0% in the hospitals, 36.4% in the academic field, and 33.3% in the others; more than half of the orthopedic surgeons were unaware of the disease.
Conclusions: More than 10% of the orthopedic surgeons had seen spinal fractures with PLO, and it was thought not to be rare. Because 5 cases were found within a year, its incidence is estimated to be 0.014%/year in Hyogo prefecture. This was a survey performed of a limited numbers of orthopedic surgeons; therefore, the expected incidence of PLO spinal fractures is thought to be higher.
