Pain Relief for Osteoporosis Patients With Fractures

(HealthDay News) -- In osteoporosis patients with spinal fractures, vertebroplasty provides significant pain relief and helps decrease disability, according to a new study.

Vertebroplasty involves injection of medical-grade bone cement into a fractured vertebra to shore up the fracture and provide pain relief. It's used to treat painful vertebral compression fractures that don't respond to conventional medical therapy with analgesics or narcotics.

The study followed 884 patients for five years who were assessed before and after vertebroplasty. Their average pre-treatment pain score on an 11-point scale decreased from 7.9 (+/- 1.5) before treatment to an average of 1.3 (+/- 1.8) after treatment.

The patients' ability to manage everyday tasks such as washing and dressing was measured using the Oswestry Disability Questionnaire. The patients' scores went from an average of 69.3 percent (+/-13.5) a month before treatment to 18.8 percent (+/- 6.9) a month after treatment.

"These data provide good news for physicians and osteoporosis patients. Many osteoporosis patients with compression fractures are in terrible pain and have a greatly diminished ability to perform basic daily activities, such as dressing themselves," Dr. Giovanni C. Anselmetti, an interventional radiologist at the Institute for Cancer Research and Treatment in Turin, Italy, said in a prepared statement.

The study also found that vertebroplasty didn't increase the risk of fracture in nearby vertebra.

"Vertebroplasty is already known to be a safe and effective treatment for osteoporotic vertebral fractures. Osteoporosis patients remain susceptible to new fractures, which often occur in the contiguous vertebra to an existing fracture. Our large-scale study shows that vertebroplasty does not increase the risk of fracture in the level contiguous to previously treated vertebra and that these new fractures occur at the same rate as they would in osteoporosis patients who did not have vertebroplasty," Anselmetti said.

The study was to be presented Tuesday at the annual scientific meeting of the Society of International Radiology.

Osteoporosis affects about 10 million Americans and causes about 1.5 million vertebral fractures each year, according to the U.S. National Institutes of Health. Multiple vertebral fractures can cause chronic pain, disability, loss of independence, stooped posture, and compression of the lungs and stomach.

More information
The American College of Radiology/Radiological Society of North American has more about vertebroplasty.

Do You Need These Tests?

Q: Do You Need These Tests?
Can you tell me what tests we all should have as we get older? Which ones do you recommend?

A: As we get older, a variety of medical tests can warn of impending problems, with hearts, bones and other chronic disorders. As long as you're in good health and have no unusual symptoms, I don't necessarily recommend an annual physical exam. But here's a list of the tests I do think everyone should have periodically as they age:

Cholesterol: This simple blood test can give you an idea of your heart disease risk. Have your cholesterol tested every five years beginning at age 20 and have your HDL ("good") cholesterol and LDL ("bad" cholesterol) checked if your total cholesterol is over 200. You should also request measurement of serum homocysteine and C-reactive protein, other indicators of heart disease risk.

Bone density: Any woman at high risk of osteoporosis (because her mother had it or because she is light boned and fair-skinned) should have this DEXA scan to determine her bone mineral density and keep track of how it is declining over time.

All women age 65 and older should have at least one DEXA scan to gauge the condition of their bones. We have good drugs to halt and reverse osteoporosis and reduce risk of hip fractures in old age. You should know, however, that DEXA tests also identify bone weakness (osteopenia) that is nowhere near the range of osteoporosis.

As a result of these findings, women may be put on the same strong drugs used to treat osteoporosis - not a wise move, in my judgment.

PSA: This test for prostate specific antigen, a protein produced by prostate cells, can warn men of prostate cancer.

However, false positives are common, and even when the test does detect cancer, it provides no information about how aggressive it is or how likely it is to spread. Until we have a reliable follow-up test to show whether or not a tumor is aggressive, I doubt the wisdom of using PSA as a screening tool, except for men at high risk of prostate cancer on the basis of family history or lifestyle. A newer test, the pro-PSA, may do better.

Discuss prostate screening with your physician.

Mammogram: Every one to two years for all women over 40 to detect early (and curable) breast cancer. Women with a positive family history of breast cancer may want to start screening earlier.

Colonoscopy: A test for early signs of colon cancer; every 10 years starting at age 50, earlier if there is a positive family history.

Blood pressure: Every two years after the age of 18 as long as your blood pressure is normal.
Eye exams: Every two to four years between ages 40 and 65; every one to two years after age 65. If you wear glasses or contacts, you should have your eyes checked annually, regardless of age.

Dental exams: Everyone, regardless of age, should have a dental check-up once or twice a year.
Full body skin exams: Check yourself monthly for moles; an annual skin exam by a physician regardless of age; follow your doctor's recommendations for more frequent exams if you've had any type of skin cancer.

Thyroid tests: All adults, particularly women, should be screened for thyroid disorders at the age of 35 and every five years thereafter.

Pap smears: Women need Pap smears to detect abnormalities that may precede cervical cancer every one to three years.

Diabetes screening: Fasting blood sugar and insulin levels should be checked if you are overweight or have a positive family history.


Weil, M.D.