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Effect of an intensive conservative therapy with daily teriparatide administration and rehabilitation for osteoporotic delayed vertebral collapse and paralysis

التفاصيل البيبلوغرافية
العنوان: Effect of an intensive conservative therapy with daily teriparatide administration and rehabilitation for osteoporotic delayed vertebral collapse and paralysis
المؤلفون: Kenta Murotani, Norimitsu Wakao, Atsuhiko Hirasawa, Toshihiro Matsuo, Masataka Deie, Mikinobu Takeuchi, Shiro Imagama, Daniel K Riew, Katsuhisa Kawanami
المصدر: Medicine. 97(23)
سنة النشر: 2018
مصطلحات موضوعية: Male, medicine.medical_specialty, medicine.medical_treatment, Treatment outcome, Conservative Treatment, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Teriparatide, medicine, Paralysis, Humans, Aged, 030203 arthritis & rheumatology, Rehabilitation, Bone Density Conservation Agents, business.industry, General Medicine, Middle Aged, Surgery, Conservative treatment, Treatment Outcome, ROC Curve, Quality of Life, Osteoporosis, Spinal Fractures, Female, Vertebral collapse, medicine.symptom, business, 030217 neurology & neurosurgery, Osteoporotic Fractures, medicine.drug
الوصف: Although patients with osteoporotic delayed vertebral collapse (ODVC) have frequently been treated surgically, the efficacy and limitation of conservative treatment for it have not yet been reported. The purpose of this study was to investigate the effectiveness and limitation of further intensive conservative treatment for patients with ODVC.Patients treated for ODVC from 2011 to 2014 with a follow-up period of more than 1 year were eligible. The fundamental treatment strategy consisted of surgical treatment following intensive conservative treatment with daily teriparatide and rehabilitation for 3 months. We conducted a surgical treatment for patients who could not keep standing position by themselves because of prolonged leg paralysis or intolerable back pain. We performed a logistic regression model in which surgical treatment was set as an objective variable, and other related factors including sex, age, the level of affected vertebrae, the quality of paralysis, changing rate (δ) of spinal canal encroachment, local kyphotic angle, mobility of collapsed vertebrae, EuroQol questionnaires (EQ5D), numerical rating scale (NRS), and Frankel grade as explanatory variables. We also plotted receiver operating curves (ROCs) to investigate the cutoff values of parameters at the baseline.Thirty patients (6 males and 24 females, mean age 76.7 years) were enrolled. Eventually 12 out of 30 patients avoided surgical treatment because their symptoms were improved. Logistic regression showed that δ of local kyphotic angle (odds ratio: 1.072), P = .01), mobility of collapsed vertebrae (1.063, 0.01), EQ5D (0.98, 0.04), and NRS (1.113, 0.01) were significantly correlated with the need for surgical treatments. Among the factors at baseline, only the mobility of collapsed vertebrae showed a significant value of area under a curve (AUC = 0.727, P = .008).The results that 40% of patients with ODVC did not need further surgical treatment after the intensive conservative treatment was of great significance. Patients with greater mobility of collapsed vertebrae might be treated surgically as quickly as possible.
تدمد: 1536-5964
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ccce1bbf622dfc72d41567fcf043a77e
https://pubmed.ncbi.nlm.nih.gov/29879028
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....ccce1bbf622dfc72d41567fcf043a77e
قاعدة البيانات: OpenAIRE
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