Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

2 results

  • Chapter 16 - Vertebral Compression Fractures

  • from Part IV - Spine
  • Edited by Omar Viswanath, Creighton University, Omaha, Ivan Urits, Southcoast Brain & Spine Center, Wareham
  • Book:
    Cambridge Handbook of Pain Medicine
    Published online:
    01 December 2023
    Print publication:
    14 December 2023, pp 107-118

  • Summary

    Vertebral compression fractures are characterized by a break in the vertebrae comprising the spinal column, most likely on the anterior side and most commonly occurring when the osseous matrix has been weakened. The high morbidity and mortality associated with VCFs have given rise to an estimated annual medical cost of $13.8 billion in the United States alone. Prevention includes screening at-risk individuals’ bone marrow density and augmenting individuals with decreased bone density with bisphosphonates or RANK ligand inhibitors. The management of VCFs has been heavily debated with arguments for both conservative management and invasive augmentation through vertebroplasty and kyphoplasty. Invasive management should be considered in patients with uncontrolled pain, significant vertebral misalignment, and height deformities.

  • Vertebral compression fracture rate following stereotactic ablative body radiotherapy for spine oligometastases: a UK experience

  • Sameed Hussain, Anjali Zarkar, Ahmed Elmodir, Daniel Ford, Sundus Yahya, Geoff Heyes, Timothy Jackson, Ruth Stange, Hannah Augustus, Jenny Sherriff
  • Journal:
    Journal of Radiotherapy in Practice / Volume 21 / Issue 4 / December 2022
    Published online by Cambridge University Press:
    14 April 2021, pp. 476-480
  • Aim:

    Stereotactic ablative body radiotherapy (SABR) for spine metastases is associated with a risk of vertebral compression fracture (VCF). The aim of this study was to determine the rate of VCF at one UK institution and evaluate the use of the Spinal Instability Neoplastic Score (SINS) to predict these.

    Materials and methods:

    A retrospective analysis of all patients who underwent SABR for spinal metastases between 2014 and 2018 at one UK institution was performed. Basic demographic data were collected, and SINS prior to SABR was calculated. The primary outcome was VCF rate. Secondary outcomes included time to VCF and need for surgical intervention following VCF.

    Results:

    A total of 48 oligometastases were treated with a median follow-up of 20·5 months. A maximum of two vertebral bodies were treated. The median baseline SINS was calculated as 3. The median dose was 26 Gy in three fractions. Two patients were reported to have VCF and both were successfully conservatively managed.

    Findings:

    SABR for spine oligometastases is being performed safely with low VCF rates which are comparable with those in international publications. This may be as a result of strict adherence to criteria for delivery of SABR with low pre-treatment SINS.