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How to Treat Osteoporotic Vertebral Fracture? Yukoh OHARA 1,2 , Takeshi HARA 1,2 , Eiji ABE 1,2 1Department of Neurosurgery, Juntendo University 2Spine and spinal cord center, Juntendo university hospital Keyword: 骨粗鬆症性椎体骨折 , 診断 , 外科的適応 , osteoporotic vertebral fracture , diagnosis , surgical indication pp.1286-1297
Published Date 2021/11/10
DOI https://doi.org/10.11477/mf.1436204514
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 In very elderly patients with low back pain, we must consider the possibility of osteoporotic vertebral fracture (OVF). In most patients with OVF, improvement can be observed without surgical intervention. However, even after providing the best possible conservative treatment, symptom recovery is not observed in some patients, and such patients experience delayed neurological deficits due to neural compression with the proceeding deformity of the vertebral body. Moreover, it is well known that once patients have OVF, the risk of another osteoporotic fracture in them increases. The clinical course of such patients eventually results in the loss of healthy life and increased mortality. Therefore, we should initiate medical treatment for osteoporosis at the earliest possible when OVF is detected in a patient. Patients who remain symptomatic even after undergoing adequate conservative therapy are candidates for balloon kyphoplasty. However, this minimally invasive surgery has some pitfalls. Furthermore, occasionally, we have to select instrumentation surgery for patients with delayed neurological deficits. In this “super-aged society,” neurosurgeons also encounter patients with OVF not only in surgical situations but also in outpatient clinics. Thus, we should be aware about the clinical options for the management of osteoporosis.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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