Exploring factors affecting activities of daily living in patients with osteoporotic vertebral fractures managed conservatively: a post-hoc analysis of a prospective cohort study.

Autor: Funayama T; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Tatsumura M; Department of Orthopaedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center/Mito Kyodo General Hospital, Mito, Japan., Fujii K; Department of Orthopaedic Surgery, Showa General Hospital, Kodaira, Japan.; Department of Orthopaedic Surgery, Kenpoku Medical Center Takahagi Kyodo Hospital, Takahagi, Japan., Shibao Y; Department of Orthopaedic Surgery, University of Tsukuba Hospital/Jichi Medical University Joint Ibaraki Western Regional Clinical Education Center/Ibaraki Western Medical Center, Chikusei, Japan., Okuwaki S; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.; Department of Orthopaedic Surgery, Kenpoku Medical Center Takahagi Kyodo Hospital, Takahagi, Japan., Sakashita K; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Sunami T; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Inomata K; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Gamada H; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Miura K; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Noguchi H; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Takahashi H; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Koda M; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan., Yamazaki M; Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Jazyk: angličtina
Zdroj: Asian spine journal [Asian Spine J] 2024 Aug; Vol. 18 (4), pp. 570-578. Date of Electronic Publication: 2024 Aug 09.
DOI: 10.31616/asj.2024.0091
Abstrakt: Study Design: A post-hoc analysis of a prospective cohort study.
Purpose: This study aimed to identify factors at the time of injury associated with declining activities of daily living (ADLs) in the chronic phase of osteoporotic vertebral fractures (OVFs) managed conservatively.
Overview of Literature: Although a conservative approach is the treatment of choice for OVFs, ADLs do not improve or eventually decrease in some cases. However, the risk factors for ADL decline after the occurrence of OVFs, particularly the difference between those with or without initial bed rest, are unknown.
Methods: A total of 224 consecutive patients with OVFs aged ≥65 years who received treatment within 2 weeks after the occurrence of injury were enrolled. The patients were followed up for 6 months thereafter. The criteria for evaluating the degree of independence were applied to evaluate ADLs. Multivariable analysis with a logistic regression model was performed to evaluate the risk factors for ADL decline.
Results: In total, 49/224 patients (21.9%) showed a decline in ADLs. Of these, 23/116 patients (19.8%) in the rest group and 26/108 patients (24.1%) in the no-rest group experienced a decline in ADLs. In the logistic regression analyses, a diffuse low signal on T2- weighted magnetic resonance imaging (MRI) (odds ratio, 5.78; 95% confidence interval, 2.09-16.0; p=0.0007) and vertebral instability (odds ratio, 3.89; 95% confidence interval, 1.32-11.4; p=0.0135) were identified as independent factors in the rest and no-rest groups, respectively.
Conclusions: In patients with acute OVFs, a diffuse low signal on T2-weighted MRI and severe vertebral instability were independently associated with ADL decline in patients treated with and without initial bed rest, respectively.
Databáze: MEDLINE
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