Early mobilization reduces the medical care cost and the risk of disuse syndrome in patients with acute osteoporotic vertebral fractures. (November 2021)

• Record Type: Journal Article
• Authors: Norimoto, Masaki; Yamashita, Masaomi; Yamaoka, Akiyoshi; Yamashita, Keishi; Abe, Koki; Eguchi, Yawara; Furuya, Takeo; Orita, Sumihisa; Inage, Kazuhide; Shiga, Yasuhiro; Maki, Satoshi; Umimura, Tomotaka; Sato, Takashi; Sato, Masashi; Enomoto, Keigo; Takaoka, Hiromitsu; Hozumi, Takashi; Mizuki, Norichika; Kim, Geundong; Ohtori, Seiji
• Is Part Of: Journal of clinical neuroscience. Volume 93(2021)
• Page Start: 155
• Page End: 159
• Publication Date: 2021-11
• Subjects: Thoracolumbar spine -- Osteoporosis -- Medical care costs -- Activities of daily living -- Conservative treatment; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2021.09.011
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: We compared two conservative treatments for acute osteoporotic vertebral fractures. Patients treated by early rehabilitation tended to maintain their pre-injury ADL status. Hospital length of stay was shorter with patients treated by early rehabilitation. Abstract: Study design: A retrospective observational study. Purpose: To compare two conservative treatments for acute osteoporotic vertebral fractures (OVFs). Overview of literature: Several studies have reported conservative treatments for OVFs in terms of using a brace, rehabilitation, and bed rest. However, there is no consensus about the conservative treatment for OVFs. Methods: We evaluated 68 patients with acute OVF treated in our hospital from 2007 to 2011. Thirty-four patients treated in prolonged bed rest (PBR) regimen underwent rehabilitation wearing a Jewett's brace after three weeks of bed rest. In contrast, the other 34 patients underwent rehabilitation wearing a Jewett's brace as soon as possible, which we called a stir-up (SU) regimen. We compared two treatment groups for medical costs, hospital length of stay (LOS), pain according to the numeric rating scale (NRS), the activities of daily living (ADL), and imaging studies. Results: The average hospital LOS was significantly shorter in patients treated by the SU regimen, which resulted in the medical costs reduction. There was no significant difference in the NRS through 6 months between the two groups. Although many patients in both groups experienced at least one level reduction in ADL at 6 months after the injury, patients in the SU group tended to maintain their pre-injury ADL, which almost agrees with past reports. In terms of imaging studies, patients in the PBR group showed milder vertebral compression rate over time. Pseudoarthrosis occurred in 2 patients in the SU group, who presented with mild pain, which had little influence on their daily lives. Conclusion: We compared two conservative treatments for OVFs. Early rehabilitation was useful treatment for OVFs to minimize the risk for disuse syndrome, maintain pre-injury ADL status, and reduce the medical costs.