Poster Presentation 50th International Society for the Study of the Lumbar Spine Annual Meeting 2024

Comparative study of the nonsurgical treatment for Osteoporotic Fracture Treatment Score (OF-score) high group and low group. (#152)

Kazuma Nagao 1 , Keishi Maruo 1 , Tomoyuki Kusukawa 1 , Tetsuto Yamaura 1 , Hayato Oishi 1 , Masakazu Toi 1 , Masaru Hatano 1 , Fumihiro Arizumi 1 , Yutaka Horinouchi 1 , Kazuya Kishima 1 , Toshiya Tachibana 1
  1. Hyogo Medical University, Nishinomiya, Hyogo, Japan, Japan

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【Introduction】

Recently, the German Society of Orthopaedic Disaster Surgery has proposed the Osteoporotic Fracture Treatment Score (OF-score) for guide in the option of nonsurgical or surgical management of osteoporotic vertebral fracture (OVF). The aim of this study to compare clinical outcome of nonsurgical treatment for OVF in patients with high and low OF-scores.

【Methods】

This study is a prospective multicenter cohort study conducted in eight hospitals. The inclusion criteria as follow: 1) acute single OVF occurring within 3 weeks, 2) aged >60 years, and 3) 12 months follow-up. The patients were divided into two groups: high group consisted of an OF-score >6 points, low group consisted of an OF-score ≦6 points. Various factors were compared between the two groups, including patient characteristics, hospitalization status, bone density, prevalent OVF, type of orthosis, anti-osteoporosis drugs, nutritional status (CONUT score), and the quality of paraspinal muscles (Goutallier classification). Clinical outcomes were compared using JOA Back Pain Evaluation Questionnaire(JOABPEQ), Oswestry Disability Index(ODI), and Visual analog scale(VAS) for low back pain (LBP). Statistical analysis was conducted using ANOVA tests, chi-squared tests, and the Turkey-Kramer test.

【Results】

A total of 107 patients (mean age 79.5 years, 82% women) met the inclusion criteria. There were 71% (76 patients) in the high group and 29% (31 patients) in the low group at baseline. The high group had significantly lower pain-related disorder (34.1 vs 48.8, p=0.02), and lumber function (28.3 vs 41.9, p=0.04) in JOABPEQ, and higher VAS for LBP(68.8 vs 54.9, p=0.01). However, there were no significant differences in JOABPEQ (except for psychological disability), lumbar VAS, and ODI between the two group at 3 and 12 months. No significant differences were observed in age, sex, BMI, CONUT score, and Goutallier classification between the two groups. However, the P group had a significantly higher rate of prevalent OVF (46.1% vs. 22.6%, p=0.02), hospitalization (65.8% vs. 29%, p<0.01), and lower total hip YAM (68.7% vs. 74.5%, p=0.047). There were no significant differences in the type of orthosis and anti-osteoporosis drugs. Significantly higher rate of severe vertebral collapse (SQ grade 3) was observed in the high group than in the low group at 12-months (57% vs 23%, p=0.002). Tended to be a higher rate of pseudoarthrosis was observed in the high group than in the low group (22% vs 10%, p=0.16).

【Discussion】

The high group, which accounted for 71% of the cases, showed equivalent clinical outcomes at 3 and 12 months between the two groups. From the results of this study, it may not be valid to determine surgical treatment based solely on the OF-score at baseline.