Bone Abstracts

Introduction: The purpose of this prospective study is to investigate whether bisphosphonate-based anti-osteoporosis medication affects fracture healing and clinical outcomes of conservatively treated osteoporotic spinal fractures (OSFs).

Method: A total of 105 patients who were diagnosed with acute OSFs were prospectively enrolled. According to their previous medication history, the patients were allocated into group I (n=39, no history of bisphosphonate use) or group II (n=66, history of bisphosphonate use). Clinical outcomes were assessed using visual analogue scale (VAS), and Oswestry disability index (ODI). Radiographic parameters including changes in height loss and kyphotic angle at the index vertebra were measured, and radiographic findings suggesting impaired fracture healing such as intravertebral cleft (IVC) sign and fracture instability were evaluated. Univariate and multivariate regression analysis were used to identify related factors.

Results: There were no significant differences in the last VAS and ODI between groups. There were also no significant differences in the radiographic parameters. Although the IVC sign was seen more commonly in group II (30.3%) than in group I (20.5%), fracture instability combined with IVC was noted in the same number of cases. On multivariate regression analysis, medication history showed no significant relationship with the clinical parameters. However, the presence of the IVC sign was related to medication history (odds ratio 4.8; 95% CI 1.01–22.69).

Conclusions: Bisphosphonate use dose not significantly affect the clinical results during conservative treatment for OSFs. However, the occurrence of the IVC sign was related to medication history. Although further studies are needed to verify our findings, there results suggest that suspension of bisphosphonate use should be considered during the fracture healing period for acute OSFs.

Keywords: Bisphosphonate, non-union, osteoporosis, osteoporotic spinal fractures.