Food and Drug Administration for the treatment and prevention of osteoporosis include bisphosphonates, calcitonin, estrogen, selective estrogen receptor modulators, parathyroid hormone, and receptor activator of nuclear factor kappa-B ligand inhibitors 6 ( Table 2 3, 8, 34, 36, 37, 39 – 41 ). Family physicians can help prevent vertebral fractures through management of risk factors and the treatment of osteoporosis.ĥ00 to 1,000 mg every four to eight hours (maximum 3 g per day)Īnalgesic-associated nephropathy (chronic), anemia, hepatotoxicity, hypersensitivity, renal tubular necrosis (acute), skin reactions, thrombocytopeniaĪnorexia, dizziness, flushing, gastrointestinal disturbance, headache, hypertension, hypocalcemia, rash, rhinitis (intranasal), weight gainĭermatitis, edema, exacerbation of pain, skin depigmentation, urticariaĪbuse, anticholinergic effects, dependence, dizziness, sedation, serotonin syndrome when combined with other serotonergic medicationsĪddiction, cognitive impairment, constipation, delirium, dizziness, hypogonadism, nausea, opioid-induced hyperalgesia, pruritus, respiratory depression, somnolence, urine retentionĪtrial fibrillation, bleeding, cardiovascular disease, edema, gastritis, gastrointestinal bleeding, heart failure, hypertension, kidney disease, peptic ulcers Percutaneous vertebral augmentation, including vertebroplasty and kyphoplasty, is controversial, but can be considered in patients with inadequate pain relief with nonsurgical care or when persistent pain substantially affects quality of life. Other conservative therapeutic options include limited bed rest, bracing, physical therapy, nerve root blocks, and epidural injections. Physicians must be mindful of medication adverse effects in older patients. Acute VCFs may be treated with analgesics such as acetaminophen, nonsteroidal anti-inflammatory drugs, narcotics, and calcitonin. More than two-thirds of patients are asymptomatic and diagnosed incidentally on plain radiography. Physical examination findings are often normal, but can demonstrate kyphosis and midline spine tenderness. Patients with an acute VCF may report abrupt onset of back pain with position changes, coughing, sneezing, or lifting. VCFs can lead to chronic pain, disfigurement, height loss, impaired activities of daily living, increased risk of pressure sores, pneumonia, and psychological distress. Fracture risk increases with age, with four in 10 white women older than 50 years experiencing a hip, spine, or vertebral fracture in their lifetime. The institute offers diagnostic and treatment options for a wide range of conditions from spinal traumas to strokes to hydrocephalus, as well as comprehensive, neuro-oncology and neuromuscular care.Vertebral compression fractures (VCFs) are the most common complication of osteoporosis, affecting more than 700,000 Americans annually. The Cooper Neurological Institute (CNI) is fully dedicated to the diagnosis and treatment of neurological and neurosurgical issues. Studies have shown that use of the Kiva System helps reduce additional VCFs in patients (35 percent reduction) resulting in fewer re-operations/re-hospitalizations (42 percent reduction) as compared to other standard treatment methods, such as balloon kyphoplasty. Kiva is FDA approved for all types of vertebral fractures including both cancer and trauma-related. “We look forward to expanding the use of Kiva in the treatment of VCF to provide patients with the best outcomes.” “The use of such cutting edge technology gives patients at Cooper more options when dealing with these types of fractures,” said Dr. The micro breaks in the vertebra can lead to severe pain and disability, and the problem is expected to grow as the population ages. The Kiva System uses a flexible implant to reduce spinal fractures and provide structural support to the spine.Įach year, about 700,000 to 1 million Americans suffer VCFs primarily due to osteoporosis and cancer. Shaikh, MD, Co-Director of Neurointerventional Surgery, who performed the procedure. “A vertebral compression fracture occurs when the block-like part of an individual bone of the spine (vertebra) become compressed due to trauma,” explained Hamza A.
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