History of fracture increases vertebral fracture disability
MedWire News: Among patients with an acute compression fracture, those with previous vertebral fractures experience greater disability and poorer quality of life (QoL) than individuals with a first fracture, study findings suggest.
Noting that around 20% of patients with an acute compression fracture experience further vertebral fractures, Tommy Hansson (Gothenburg University, Sweden) and co-workers hypothesized that history of vertebral fractures could explain discrepancies in pain, disability, and QoL between vertebral fracture patients.
To investigate, the team followed-up 51 patients with and 56 patients without a prior vertebral fracture for 12 months. The patients were assessed 3 weeks after injury and again after 3, 6, and 12 months using the von Korff pain and disability scores, the Hannover Activities of Daily Living (ADL) score, and the EQ-5D QoL score.
As reported in the European Spine Journal, patients had experienced significant improvements on all measures between baseline and 3 months, but patients with a history of acute compression fractures experienced a poorer outcome than those without.
Specifically, those with a history of fractures had a significantly poorer disability score at 3 weeks, and at 6 and 12 months, QoL at all time points, and ADL scores at 3, 6, and 12 months than those without. However, pain was only significantly greater in patients with a history of fracture at 12 months.
Further analysis showed a significant correlation between increasing number of previous fractures and poorer outcome in all the measures except for pain intensity at 3 weeks and 3 months, and disability at 3 months.
“The previous fracture(s) worsened the outcomes from the beginning and continued up to at least 1 year,” Hansson et al conclude.
“Therefore, for the prognosis and indication of treatments such as kyphoplasty or vertebroplasty, the influences of a previous fracture(s) should be considered.”
They recommend that an extended study follow-up would improve understanding of the impact of a previous fracture on vertebral fracture healing, perhaps by demonstrating the effect on speed of recovery.
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By Lynda Williams