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Vertebral Compression Fractures

Adrien Selim, MD and Joe Weatherly, DO
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Vertebral compression fractures are the most common osteoporotic fractures.  They can be caused by low force activities, such as coughing, straining at stool, or as in this case, trying to open a frozen front door.  Plain films are the diagnostic modality of choice, although CT and MRI may also be needed depending on your differential diagnosis and treatment plan. While many respond well to conservative management with pain control or bracing, some patients will require surgery.


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Casey P. -

Hi Guys
Did you see this Aussie paper out of Sydney? VAPOUR - maybe Vertebroplasty helps?

Clark W, Bird P, Gonski P. Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 388(10052):1408-1416.

It s well done trial, that seems to show some benefit if vertebroplasty is used early.
This is very much a tricky area, complex patients with many comorbidities. The risks are high all round

Adrien Selim -

Hey Casey,

No, unfortunately we didn't see that article, it was published after the recording. Thanks for sharing it, really interesting study.

Agree that this a complex area. But with the potential benefit of kyphoplasty and vertebroplasty probably a good idea to get our spinal surgery colleagues on board earlier rather than later.

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The Benzos & Fungus Among Us Full episode audio for MD edition 169:10 min - 79 MB - M4AHippo Primary Care RAP March 2017 Summary 563 KB - PDF