SIR 2024
Pain Management/MSK
Sophia M. Durney, BS (she/her/hers)
Medical Student
Kaiser Permanente Bernard J Tyson School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Kevin Zhou, BA
Medical Student
Kaiser Permanente School of Medicine
Disclosure information not submitted.
Alok Bhatt, MD
Assistant Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente physician
Financial relationships: Full list of relationships is listed on the CME information page.
Kavenpreet Bal, MS
Medical Student
Kaiser Permanente Bernard J. Tyson School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
To review diagnostic criteria and medical management strategies for osteoporosis and compare outcomes for surgical and nonsurgical interventions in osteoporotic-related fractures. This exhibit will: Provide an overview of demographics most at risk for developing osteoporosis. Describe and review diagnostic criteria for osteoporosis including BMD and T-score, and address methods to differentiate confounding diseases such as chronic kidney disease-metabolic bone disease and myeloma in patients with low bone density. Review efficacy, indications, and challenges of pharmacotherapies for osteoporosis including bisphosphonates, denosumab, teriparatide parathyroid hormone (PTH), raloxifene, calcitonin, and hormone replacement therapy (HRT). Describe clinical practice guidelines for physical therapy in patients with osteoporosis, including beneficial outcomes or adverse events associated with exercise mode, frequency and duration, and patient characteristics {1}. Review evidence for and against TLSO back braces as supportive therapy for patients with osteoporosis {2}. Review patient morbidity, mortality, and quality of life after osteoporotic-related fractures and surgery {3,4,5,6}.
Background: Osteoporosis is a systemic, metabolic bone disease characterized by low bone mass density, impaired bone quality, and susceptibility to low-trauma fracture {1}. VIR physicians are commonly involved in managing patients with osteoporotic compression fractures and can play an important role in preventing fracture recurrence by ensuring a thorough workup and holistic management strategy for these patients. This exhibit will highlight the indications, efficacies, and complications of pharmacotherapies, physical therapies, and supportive therapies for osteoporosis across different patient demographics, as well as review patient outcomes after osteoporotic-related fractures and surgical interventions.
Clinical Findings/Procedure Details:
Conclusion and/or Teaching Points: Fragility fractures that occur from low-trauma forces result in increased morbidity, mortality, hospitalizations, and clinical burden, and reduced quality of life {1,4,5}. Therefore, it is critical to understand diagnostic guidelines for osteoporosis and determine the efficacy of pharmacotherapies, physical therapies, and non-operative methods such as TSLO back braces in management of the disease. Given the high mortality rates associated with low-trauma hip, spine, and femur fractures, it is valuable to review outcomes associated with different surgical interventions used to treat these injuries.