Osteoporotik Vertebra Kırıklarının Retrospektif Analizi

Yıl 2023, , 319 - 323, 20.12.2023

Ali Akar

https://doi.org/10.46332/aemj.1220863

Öz

Amaç: Osteoporotik vertebra kırığı (OPVK) ileri yaşlarda oldukça sık görülen patolojilerdir. Bu çalışma ile OPVK hastaların, osteoporoz (OP) düzeyleri ve tedavi alışkanlıkları ile OPVK nedenleri ve tedavi şekilleri arasındaki ilişkiyi ortaya koymayı amaçladık.

Araçlar ve Yöntem: OPVK nedeni tedavi edilen 50 yaş üzeri 65 olgu retrospektif olarak incelendi. Hastaların müracaatları esnasında OP tanısı (var-yok) ve tedavileri (var-yok) olup olmadığına göre ayrıldı. OPVK tedavisi esnasındaki DEXA sonuçlarına göre hastalar osteopeni (T skoru -1 ve -2.5 arası) ve OP (T skoru<-2.5) olarak iki gruba ayrıldı. OPVK nedenlerine göre trafik kazası, düşme ve travma yok ve tedavi şekillerine göre medikal, kifoplasti ve posterior stabilizasyon olarak 3 gruba ayrıldı.

Bulgular: Hastaların OPVK nedeni ile kliniğimize müracaatı esnasında hiçbirinde OP tanısının olmadığı, dolayısı ile OP medikal tedavisi almadığı görüldü. Kadın ve erkek cinsiyet arasında DEXA değerlerinde anlamlı bir fark olduğu tespit edildi (p=0.045). Yaş kategorisi ve OPVK nedenleri ile DEXA değerlerinin arasında anlamlı bir ilişki yoktu (p=0.144, p=0.163).

Sonuç: Osteoporoz ve OPVK yaşam süresi uzadıkça giderek daha büyük ve daha önemli bir halk sağlığı sorunu haline gelmektedir. OPVK’dan korunmak için, OP’nin erken tanı ve tedavisi önemlidir. OP ve tarama yöntemleri için farkındalığın arttırılması gerekmektedir.

Anahtar Kelimeler

Osteoporoz, Vertebra Kırığı, Tedavi, Kifoplasti

Destekleyen Kurum

yok

Retrospective Analysis of Osteoporotic Vertebral Fractures

Öz

Purpose: Osteoporotic vertebral fracture (OPVC) is a common pathology in the elderly. In this study, we aimed to investigate the relationship between osteoporosis (OP) levels and the treatment habits of OPVC patients, as well as the causes and treatment modalities of OPVC.

Material and Methods: We retrospectively analyzed 65 cases over 50 years of age who were treated for OPVC. Patients were divided based on whether they had a diagnosis of OP (yes or no) and whether they received treatments (yes or no) at the time of their application. According to DEXA results during OPVC treatment, patients were categorized into two groups as osteopenia and OP. They were also divided into three groups based on the causes of OPVC: traffic accident, fall, and no trauma, and into three groups based on the treatment methods: medical treatment, kyphoplasty, and posterior stabilization.

Results: None of the patients had a diagnosis of OP at the time of their application to our clinic for OPVC, and therefore, they did not receive medical treatment for OP. We observed a significant difference in DEXA values between male and female genders (p=0.045). However, there was no significant relationship between age categories, causes of OPVC, and DEXA values (p=0.144, p=0.163).

Conclusion: Osteoporosis and OPVC are becoming increasingly significant public health problems as life expectancy continues to rise. Early diagnosis and treatment of OP are essential in preventing OPVC. Awareness regarding OP and screening methods needs to be increased.

Anahtar Kelimeler

Osteoporosis,, Vertebral Fracture, Treatment, Kyphoplasty

Kaynakça

• 1. Kutsal FY, Ergin Ergani GO. Vertebral compression fractures: Still an unpredictable aspect of osteoporosis. Turk J Med Sci. 2021;30;51(2):393-399.
• 2. Yilmaz A, Çakir M, Yücetaş CŞ, et al. Percutaneous Kyphoplasty: Is Bilateral Approach Necessary? Spine (Phila Pa 1976). 2018;15;43(14):977-983.
• 3. Cooper C, Atkinson EJ, O’Fallon WM, et al. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res. 1992;7(2):221-227.
• 4. Salari N, Darvishi N, Bartina Y, et al. Global prevalence of osteoporosis among the world older adults: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2021;13;16(1):669.
• 5. Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16(2):3-7.
• 6. Delmas PD, Van de Langerijt L, Watts NB, et al. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res. 2005;20(4):557-563.
• 7. Malçok ÜA, Şafak Ö, Akman T, Aras AB. Kifoplasti ve Vertebroplasti Operasyonlarının Klinik ve Radyolojik Olarak Değerlendirilmesi. Kafkas J Med Sci. 2020;10(1):1-7.
• 8. Heini PF, Walchli B, Berlemann U. Percutaneous transpedicular vertebroplasty with PMMA: operative technique and early results. A prospective study for the treatment of osteoporotic compression fractures. Eur Spine J. 2000;9:445-450.
• 9. Capdevila-Reniu A, Navarro-López M, López-Soto A. Osteoporotic vertebral fractures: A diagnostic challenge in the 21 st century. Rev Clin Esp (Barc). 2021;221(2):118-124.
• 10. Felsenberg D, Silman AJ, Lunt M, et al. Incidence of vertebral fracture in europe: results from the European Prospective Osteoporosis Study (EPOS). J Bone Miner Res. 2002;17(4):716-724.
• 11. Tuzun S, Eskiyurt N, Akarirmak U, et al. Turkish Osteoporosis Society. Incidence of hip fracture and prevalence of osteoporosis in Turkey: the Fracturk study. Osteoporos Int. 2012;23(3):949-955.
• 12. Camacho PM, Petak SM, Binkley N, et al. American Associatıon of Clinical Endocrinologists/Amerıcan College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2020;26(1): 1-46.
• 13. Orimo H, Nakamura T, Hosoi T, et al. Japanese 2011 guidelines for prevention and treatment of osteoporosis-executive summary. Arch Osteoporos. 2012;7(1): 3-20.
• 14. Sozen, T., Gogas Yavuz, D., & Akalın, A. Metabolik kemik hastalıkları tanı ve tedavi kılavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği. 2014; 1: 19-27.
• 15. Prost S, Pesenti S, Fuentes S, Tropiano P, Blondel B. Treatment of osteoporotic vertebral fractures. Orthop Traumatol Surg Res. 2021;107(1):102779.
• 16. Liu T, Li Z, Su Q, Hai Y. Cement leakage in osteoporotic vertebral compression fractures with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty surgery. Medicine (Baltimore). 2017;96(25):7216.
• 17. Hulme PA, Krebs J, Ferguson SJ, Berlemann U. Vertebroplasty and kyphoplasty: A systematic review of 69 clinical studies.Spine. 2006; 31(17): 1983-2001.
• 18. Li KC, Li AF, Hsieh CH, Liao TH, Chen CH. Another option to treat Kümmell's disease with cord compression. Eur Spine J. 2007;16(9):1479-1487.
• 19. Long Y, Yi W, Yang D. Advances in Vertebral Augmentation Systems for Osteoporotic Vertebral Compression Fractures. Pain Res Manag. 2020;7:3947368.