EMAS position statement: The management of postmenopausal women with vertebral osteoporotic fracture

Ioannis K Triantafyllopoulos; Kalliopi Lambropoulou-Adamidou; Cleopatra C Nacopoulos; Nikolaos A Papaioannou; Iuliana Ceausu; Herman Depypere; C Tamer Erel; Faustino R Pérez-López; Karin Schenck-Gustafsson; Yvonne T van der Schouw; Tommaso Simoncini; Florence Tremollieres; Margaret Rees; Irene Lambrinoudaki; European Menopause and Andropause Society

doi:10.1016/j.maturitas.2014.03.002

EMAS position statement: The management of postmenopausal women with vertebral osteoporotic fracture

Maturitas. 2014 Jun;78(2):131-7. doi: 10.1016/j.maturitas.2014.03.002. Epub 2014 Mar 7.

Authors

Ioannis K Triantafyllopoulos¹, Kalliopi Lambropoulou-Adamidou², Cleopatra C Nacopoulos³, Nikolaos A Papaioannou⁴, Iuliana Ceausu⁵, Herman Depypere⁶, C Tamer Erel⁷, Faustino R Pérez-López⁸, Karin Schenck-Gustafsson⁹, Yvonne T van der Schouw¹⁰, Tommaso Simoncini¹¹, Florence Tremollieres¹², Margaret Rees¹³, Irene Lambrinoudaki¹⁴; European Menopause and Andropause Society

Affiliations

¹ Laboratory of Research for the Musculoskeletal System (LRMS), School of Medicine, University of Athens, 10 Athinas Street, 14561 Kifissia, Greece. Electronic address: sportdoc@otenet.gr.
² Medical School, University of Athens, KAT General Hospital, 2 Nikis Street, 14561 Kifissia, Greece.
³ Medical School, University of Athens, 10 Athinas Street, 14561 Kifissia, Greece.
⁴ Laboratory of Research for the Musculoskeletal System (LRMS), School of Medicine, University of Athens, 10 Athinas Street, 14561 Kifissia, Greece.
⁵ Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania; Department of Obstetrics and Gynecology, 'Dr. I. Cantacuzino' Hospital, Bucharest, Romania.
⁶ Breast Clinic and Menopause Clinic, University Hospital, De Pintelaan 185, 9000 Gent, Belgium.
⁷ Department of Obstetrics and Gynecology, Istanbul University, Cerrahpasa School of Medicine, Valikonagi Cad. No. 93/4, Nisantasi, 34365 Istanbul, Turkey.
⁸ Department of Obstetrics and Gynecology, Zaragoza University Facultad de Medicina, Hospital Clínico, Zaragoza 50009, Spain.
⁹ Department of Medicine, Cardiology Unit and Head Centre for Gender Medicine, Karolinska Institutet and Karolinska University Hospital, Thorax N3:06, SE 17176 Stockholm, Sweden.
¹⁰ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
¹¹ Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy.
¹² Menopause and Metabolic Bone Disease Unit, Hôpital Paule de Viguier, F-31059 Toulouse cedex 09, France.
¹³ Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.
¹⁴ Second Department of Obstetrics and Gynecology, National and Capodestrian University of Athens, Greece.

PMID: 24679890
DOI: 10.1016/j.maturitas.2014.03.002

Abstract

Introduction: Osteoporotic vertebral fractures are associated with significant morbidity, excess mortality as well as health and social service expenditure. Additionally, women with a prevalent osteoporotic vertebral fracture have a high risk of experiencing a further one within one year. It is therefore important for the physician to use a diagnostic and therapeutic algorithm for early detection and effective treatment of vertebral fractures.

Aims: The aim of this position statement is to provide and critically appraise evidence on the management of women with a vertebral osteoporotic fracture.

Materials and methods: Literature review and consensus of expert opinion.

Results and conclusions: The management of women with osteoporotic vertebral fractures includes measures to reduce pain providing early mobility, to support the affected spine ensuring fracture healing, as well as starting treatment for osteoporosis itself. Any other underlying pathology should be sought and treated. Early detection and treatment is essential as there is an increased risk of further fractures in patients with vertebral fractures. Treatment will depend on the underlying causes of bone loss, efficacy in any particular situation, cost and patient preference.

Keywords: Conservative treatment; Diagnosis; Osteoporosis; Surgical treatment; Vertebral fracture.

Publication types

Practice Guideline
Review

MeSH terms

Consensus
Disease Management*
Female
Humans
Osteoporosis, Postmenopausal / complications*
Osteoporosis, Postmenopausal / diagnosis
Osteoporotic Fractures / diagnosis
Osteoporotic Fractures / etiology
Osteoporotic Fractures / therapy*
Postmenopause*
Spinal Fractures / diagnosis
Spinal Fractures / etiology
Spinal Fractures / therapy*
Spine / pathology*
Women's Health