Article

Clinical course of pain in acute osteoporotic vertebral compression fractures.

Department of Radiology, St. Elisabeth Hospital, Hilvarenbeekseweg 60, Tilburg, NL 5022 GC, The Netherlands.
Journal of vascular and interventional radiology: JVIR (impact factor: 1.81). 09/2010; 21(9):1405-9. DOI:10.1016/j.jvir.2010.05.018 pp.1405-9
Source: PubMed

ABSTRACT The authors prospectively determined the natural course of pain in patients with conservatively treated acute osteoporotic vertebral compression fractures (VCF). In addition, the type of conservative therapy that these patients received was assessed.
Patients older than 50 years, referred for spine radiography for acute back pain, were asked to complete a baseline clinical questionnaire. Patients with an acute VCF were followed up at 6 and 23 months with a questionnaire that included a Visual Analog Score (VAS) and type of pain medication and other conservative treatment. Significant pain relief was defined as a decrease in VAS of 50% or more.
Forty-nine patients (mean age, 78 years; range, 51-95) with acute VCF were followed up for almost 2 years. Significant pain relief was noted in 22 of 35 patients (63%) at 6 months and in 25 of 36 (69%) at 23 months. In patients with persisting pain at 23 months (mean VAS 6.4), some decrease in VAS was apparent at 6 months but not in the 6-23 months interval. No predictors for significant pain relief could be identified. Patients with significant pain relief used less pain medication and had less physical therapy.
In most patients with an acute VCF, pain decreases significantly with conservative therapy, predominantly in the first 6 months. However, almost 2 years after an acute VCF, a third of patients still had severe pain necessitating pain medication and physical therapy in the majority. No predictors for transition from acute to chronic pain could be identified.

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Keywords

23 months
 
35 patients
 
6 months
 
6-23 months interval
 
acute osteoporotic vertebral compression fractures
 
acute VCF
 
authors prospectively
 
chronic pain
 
conservative therapy
 
conservative treatment
 
first 6 months
 
natural course
 
pain decreases
 
pain medication
 
Patients
 
Patients older
 
persisting pain
 
physical therapy
 
significant pain relief
 
Visual Analog Score