Preventive effects of conservative treatment with short-term teriparatide on the progression of vertebral body collapse after osteoporotic vertebral compression fracture

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J.-H. Park, K.-C. Kang, D.-E. Shin, Y.-G. Koh, J.-S. Son, B.-H. Kim

Osteoporosis International,  doi: 10.1007/s00198-013-2458-7

ABSTRACT

Summary

The progression of fractured vertebral collapse is not rare after a conservative treatment of vertebral compression fracture (VCF). Teriparatide has been shown to directly stimulate bone formation and improve bone density, but there is a lack of evidence regarding its use in fracture management. Conservative treatment with short-term teriparatide is effective for decreasing the progression of fractured vertebral body collapse.

Introduction

Few studies have reported on the prevention of collapsed vertebral body progression after osteoporotic VCF. Teriparatide rapidly enhances bone formation and increases bone strength. This study evaluated preventive effects of short-term teriparatide on the progression of vertebral body collapse after osteoporotic VCF.

Methods

Radiographs of 68 women with single-level osteoporotic VCF at thoracolumbar junction (T11?L2) were reviewed. Among them, 32 patients were treated conservatively with teriparatide (minimum 3 months) (group I), and 36 were treated with antiresorptive (group II). We measured kyphosis and wedge angle of the fractured vertebral body, and ratios of anterior, middle, and posterior heights of the collapsed body to posterior height of a normal upper vertebra were determined. The degree of collapse progression was compared between two groups.

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 (4.0??4.2 and 3.6??3.6) than in group II (6.8??4.1 and 5.8??3.5) (p?=?0.032 and p?=?0.037). Decrement percentages of anterior and middle border height were significantly lower in group I (9.6??10.3 and 7.4??7.5 %) than in group II (18.1??9.7 and 13.8??12.2 %) (p?=?0.001 and p?=?0.025), but not in posterior height (p?=?0.086).

Conclusions

In female patients with single-level osteoporotic VCF at the thoracolumbar junction, short-term teriparatide treatment did not prevent but did decrease the progression of fractured vertebral body collapse.

Keywords: Collapse progression, Osteoporosis, Teriparatide, Vertebral compression fracture

- PubMed ID: 23943161

- Fulltext Link: http://link.springer.com/article/10.1007%2Fs00198-013-2458-7