Bone Abstracts

Introduction: Acute vertebral compression fractures cause severe back pain and need long time to heal. The progression of fracture or nonunion is not rare. The teriparatide is a synthetic parathyroid hormone which has been used as anabolic agent and treatment of osteoporosis. It can also be used for promoting fracture healing in special condition. Periodic infusion of teriparatide enhances bone formation and increases bone strength. We evaluated the effect of periodic teriparatide infusion on fracture healing of acute vertebral compression fractures.

Methods: A prospective study consisting of a review of case report form. We prospectively enrolled 84 postmenopausal women who had one or two acute painful vertebral compression fractures confirmed by MRI. All patients were treated conservatively. Among them, 32 patients were treated conservatively with teriparatide for at least 6 months (group I), and 52 were treated with antiresorptive agent (group II). VAS and ODI scores were assessed at each follow up until 1 year after trauma. We also measured radiographic changes, the degree of collapse progression.

Results: The progression of fractured vertebral body collapse was shown in both groups, but the degree of progression was significantly lower in group I than in group II. At the last follow-up, mean increments of kyphosis and wedge angle were significantly lower in group I. Clinical outcome measures were closely related with vertebral body collapse.

Conclusion: Periodic infusion of teriparatide might have many beneficial effects on acute vertebral compression fractures in postmenopausal women. Patients using teriparatide showed quicker symptomatic improvement and less collapsed vertebral body 1 year after trauma compared to patients using anti-resorptive agent.