OSTEOPOROSIS AND SPINAL SURGERY
|
|
|
- Bethanie Jacobs
- 7 years ago
- Views:
Transcription
1 OSTEOPOROSIS AND SPINAL SURGERY IRA FEDDER, PharmD, MD Scoliosis and Spine Center Clinical Reality Aging population Increased demand for surgery regardless of age Bone loss is universal Inactivity and Vitamin D deficiency Glucocorticoid use 1
2 OSTEOPOROSIS AND SPINE COMPLICATIONS DEWALD CJ ET AL. SPINE 26;31(19 SUPPL):S TOYONE T, ET AL. SPINE 21;35: Surgical Strategies Modified instrumentation- e.g.osteoporosis screws Modified screw insertion techniques technique e.g.cortical screws Anterior and posterior stabilization Cement augmentation Medical strategies Calcium/Vitamin D Anti- resorptive agents-- bisphosphonates, denosumab (Prolia) Anabolic agents Teriparatide ( 1-34 PTH) 2
3 Rat GC Treated Fusion Model The Spine Journal 15(215) N ENGL J MED 27;357: COMPARED TERIPARATIDE TO ALENDRONATE BMD WAS BETTER IN TERIPARATIDE GROUP FEWER FRACTURES J Am Acad Orthop Surg 215; 23(4):
4 Teriparatide Fracture Prevention Trial Study Design Endpoints: Vertebral and non-vertebral fracture, BMD Prospective, randomized, double-blind, multi-national trial in 1637 postmenopausal women with prior vertebral fracture, 2 mcg, or 4 mcg recombinant human PTH(1-34) (teriparatide, TPTD) (Eli Lilly and Company) by once daily self-injection SC for up to 2 years (median 19 months) Supplemental calcium 1, mg/day and vitamin D 4-1,2 IU/day Neer et al. N Engl J Med 21; 344: Teriparatide Fracture Prevention Trial Inclusion Criteria Ambulatory women > 5 years postmenopausal with prior nontraumatic vertebral fractures, as follows: > 2 moderate fractures > 2 mild fractures + hip or spine BMD T-score < moderate fracture + hip or spine BMD T-score < -1. Neer et al. N Engl J Med 21; 344: Teriparatide Fracture Prevention Trial Baseline Characteristics (mean ± SD) TPTD2 TPTD4 Age (years) Years postmenopausal Previous OP therapy (%) Spine sbmd (mg/cm 2 ) Spine T-score Vertebral fractures N = ± 7 21 ± ± N = ± 7 21 ± ± N = ± 7 22 ± ± % 62% 31% 6% 32% 58% sbmd = BMD standardized for machine differences Neer et al. N Engl J Med 21; 344:
5 Efficacy Effect of Teriparatide on the Risk of Moderate and Severe New Vertebral Fractures Number of Women with Moderate or Severe Vertebral Fractures RR.22 (95% CI,.11 to.45)* RR.1 (95% CI,.4 to.27)* (n=448) Risk Reduction 9% 8.5% TPTD2 (n=444) 78% 7.3% TPTD4 (n=434) % of Women Neer et al. N Engl J Med 21; 344: * P <.1 vs. Effect of Teriparatide on the Risk of Multiple New Vertebral Fractures Number of Women with 2 or More New Vertebral Fractures RR.14 (95% CI,.4 to.47)* RR.23 (95% CI,.9 to.6)* (n=448) Risk Reduction 77% 3.8% TPTD2 (n=444) 86% 4.2% TPTD4 (n=434) % of Women Neer et al. N Engl J Med 21; 344: *P <.1 vs. 5
6 INSTRUMENTED FUSION OVER 5 HISTORY OF FRAGILITY FRACTURE HISTORY OF TREATMENT OF OSTEOPOROSIS WITH BISPHOSPHONATES METABOLIC/PHARMACOLOGIC ISSUE PREMATURE MENOPAUSE EVAL AND TREATMENT HISTORY- STEROIDS/METABOLIC/FRACTURES/EAR LY MENOPAUSE DEXA VITAMIN D3 (MEASURE 25-OH VITAMIN D CALCIUM TERIPARATIDE PROS ANABOLIC AGENT FEW REVERSABLE SIDE EFFECTS CREATES BONE/IMPROVED BONE MASS CONS DAILY SELF INJECTION COST 6
7 THANK YOU Semiquantitative Evaluation of Vertebral Fracture Severity Fracture Grade - Normal Anterior Middle Posterior 1- Mild (2-25%) M 2- Moderate (26-4%) M M 3- Severe (>4%) Adapted from J Bone Miner Res 1993; 8: with permission of the American Society for Bone and Mineral Research Teriparatide Fracture Prevention Trial Study Duration (from randomization to last radiograph) 25 Number of Women ~2 3~5 6~8 9~11 12~14 15~17 18~2 21~23 24~26 >=27 Months Completed TPTD2 TPTD4 Data on File, Eli Lilly and Company 7
8 Effect of Teriparatide on the Risk of New Vertebral Fractures Number of Women with 1 or More New Vertebral Fractures RR.31 (95% CI,.19 to.5)* RR.35 (95% CI,.22 to.55)* (n=448) Risk Reduction 65% 9.3% TPTD2 (n=444) 69% 9.9% TPTD4 (n=434) % of Women Neer et al. N Engl J Med 21; 344: *P <.1 vs. Incidence of New or Worsening Back Pain 1 No. of women (%) 123 (23) TPTD2 91 (17)* TPTD4 87 (16)** Fracture-Associated Height Loss Centimeters lost 1.11 TPTD2.21** TPTD4.31* 1 Incidence of new or worsening back pain was recorded as adverse event *P<.5 vs. **P<.1 vs. Neer et al. N Engl J Med 21; 344: Effect of Teriparatide 2mcg Patient 1124 B3D-MC-GHAC UCSF - Jiang Baseline Follow-up Female, age 65 Duration of therapy: 637 days (approx 21 mos) BMD Change: Lumbar Spine: +7.4% (group mean = 9.7 ± 7.4%) Total Hip: +5.2% (group mean = 2.6 ± 4.9%) 8
9 Effect of Teriparatide on Bone Histology Patient mcg/day Patient mcg/day Baseline Endpoint Data on File, Eli Lilly and Company 9
Fast Facts on Osteoporosis
Fast Facts on Osteoporosis Definition Prevalence Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an
Orthopaedic Issues in Adults with CP: If I Knew Then, What I Know Now
Orthopaedic Issues in Adults with CP: If I Knew Then, What I Know Now Laura L. Tosi, MD Director, Bone Health Program Children s National Medical Center Washington, DC Epidemiology 87-93% of children born
Drug treatment pathway for Osteoporosis in Postmenopausal Women
Drug treatment pathway for Osteoporosis in Postmenopausal Women Version 1.0 Ratified by: East Sussex HEMC Date ratified: 26.01.2011 Job title of originator/author Gillian Ells, East Sussex HEMC Pharmacist
Module 5 - Speaking of Bones Osteoporosis For Health Professionals: Fracture Risk Assessment. William D. Leslie, MD MSc FRCPC
Module 5 - Speaking of Bones Osteoporosis For Health Professionals: Fracture Risk Assessment William D. Leslie, MD MSc FRCPC Case #1 Age 53: 3 years post-menopause Has always enjoyed excellent health with
Drug treatments for osteoporosis
Drug treatments for osteoporosis What is osteoporosis? Osteoporosis occurs when the struts which make up the mesh-like structure within bones become thin causing them to become fragile and break easily,
Recent Topics in Treatment of Osteoporosis
Review Article Recent Topics in Treatment of Osteoporosis JMAJ 49(9 10): 309 314, 2006 Satoshi Soen* 1 Abstract It has come to light that osteoporosis-related fractures are more critical than previously
Medications for Prevention and Treatment of Osteoporosis
1 Medications for Prevention and Treatment of Osteoporosis Osteoporosis is a disease where the strength of bones is less than normal, making them more susceptible to fracture, or breaking, than normal
Measure #41: Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older National Quality Strategy Domain: Effective Clinical Care
Measure #41: Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY
Clinical Policy Guideline
Clinical Policy Guideline Policy Title: Bone Density Testing Policy No: B0215A.00 Effective Date: 01/01/15 Date Reviewed: 03/25/15 I. DEFINITION/BACKGROUND Bone density testing is used to estimate the
Osteoporosis has been identified by the US Surgeon General
New Guidelines for the Prevention and Treatment of Osteoporosis E. Michael Lewiecki, MD, and Nelson B. Watts, MD Abstract: The World Health Organization Fracture Risk Assessment Tool (FRAX ) and the National
A Treatment Algorithm for Indian Patients of Osteoporosis
Indian Medical Gazette FEBRUARY 2012 67 Symposia Update A Treatment Algorithm for Indian Patients of Osteoporosis Shailendra Mohan Lakhotia, Senior Consultant Orthopedic Surgeon, Kolkata 700 045. Prashant
Advances In Spine Care. James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery
Advances In Spine Care James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery Introduction The Spine - A common source of problems Back pain is the #2 presenting
Falls and Fracture Risk assessment and management
Falls and Fracture Risk assessment and management Disclosures: Although various guidelines and studies were reviewed, this represents my own personal bias and conclusions. What do we know? 1) Fractures
COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) GUIDELINE ON THE EVALUATION OF MEDICINAL PRODUCTS IN THE TREATMENT OF PRIMARY OSTEOPOROSIS
European Medicines Agency London, 16 November 2006 Doc. Ref. CPMP/EWP/552/95 Rev. 2 COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) GUIDELINE ON THE EVALUATION OF MEDICINAL PRODUCTS IN THE TREATMENT
Clinical Practice Guideline for Osteoporosis Screening and Treatment
Clinical Practice Guideline for Osteoporosis Screening and Treatment Osteoporosis is a condition of decreased bone mass, leading to bone fragility and an increased susceptibility to fractures. While osteoporosis
Cystic fibrosis and bone health
Cystic fibrosis and bone health Factsheet March 2013 Cystic fibrosis and bone health Introduction As we get older our bones become thinner and weaker, and may become more susceptible to fracture. However
Care pathways for vertebral compression fractures
Care pathways for vertebral compression fractures SYDNEY MEDICAL SCHOOL Associate Professor Manuela L Ferreira, PhD Sydney Medical Foundation Fellow Institute of Bone and Joint Research and The George
BULLETIN. Slovak Republic Ministry of Health
BULLETIN Slovak Republic Ministry of Health Part 51-53 November 13, 2009 No. 57 CONTENTS: 52. Slovak Republic Ministry of Health Guidelines for the Diagnosis of Glucocorticoidinduced Osteoporosis 52. Slovak
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) OSTEOPOROSIS GUIDELINE
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) OSTEOPOROSIS GUIDELINE This is an updated guideline It incorporates the latest NICE guidance There are strong recommendations for calcium + vitamin D
How To Take A Bone Marrow Transplant
Drug treatments to protect your bones This information is an extract from the booklet, Bone health. You may find the full booklet helpful. We can send you a copy free see page 5. Contents Bisphosphonates
RISK EVALUATION AND MITIGATION STRATEGY (REMS)
Page 1 Initial REMS Approval: July 2009 Most Recent Modification: August 2013 NDA 21-318 FORTEO (teriparatide) (rdna origin) Injection RISK EVALUATION AND MITIGATION STRATEGY (REMS) Eli Lilly and Company
Osteoporosis/Bone Health in Adults as a National Public Health Priority
Position Statement Osteoporosis/Bone Health in Adults as a National Public Health Priority This Position Statement was developed as an educational tool based on the opinion of the authors. It is not a
Bone Densitometry. What is a Bone Density Scan (DXA)?
Scan for mobile link. Bone Densitometry Bone densitometry, also called dual-energy x-ray absorptiometry or DEXA, uses a very small dose of ionizing radiation to produce pictures of the inside of the body
X-Plain Vertebral Compression Fractures Reference Summary
X-Plain Vertebral Compression Fractures Reference Summary Introduction Back pain caused by a vertebral compression fracture, or VCF, is a common condition that affects thousands of people every year. A
Osteoporosis Assessment Using DXA and Instant Vertebral Assessment. Working Together For A Healthier Community
Osteoporosis Assessment Using DXA and Instant Vertebral Assessment Working Together For A Healthier Community Osteoporosis The Silent Thief The Facts About Osteoporosis 1 in 2 women will develop osteoporosis
PRACTICAL DENSITOMETRY
PRACTICAL DENSITOMETRY The Challenge of Osteoporosis Osteoporosis is a silent disease that develops over decades Goal: identify patients with osteoporosis before fractures occur Means: measure bone density
PROTOCOL FOR PATIENTS WITH ABNORMAL LAB AND X-RAY VALUES
PROTOCOL FOR PATIENTS WITH ABNORMAL LAB AND X-RAY VALUES Patients newly diagnosed as osteopenic or osteoporotic on a radiology report or patients receiving abnormal lab values on the following lab tests
Medications to Prevent and Treat Osteoporosis
Medications to Prevent and Treat Osteoporosis National Institutes of Health Osteoporosis and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD 20892-3676 Tel: (800) 624-BONE or
Osteoporosis and Arthritis: Two Common but Different Conditions
and : Two Common but Different Conditions National Institutes of Health and Related Bone Diseases ~ National Resource Center 2 AMS Circle Bethesda, MD 20892 3676 Tel: 800 624 BONE or 202 223 0344 Fax:
NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Rehabilitation of Patients With Fragility-Related Fractures CE APPLICATION FORM
NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Rehabilitation of Patients With Fragility-Related Fractures CE APPLICATION FORM First Name: Last Name: Mailing Address: City: State: Zip/Postal
CPT 76977, 77078, 77079, 77080, 77081, 77083, or HCPCS G0130:
Bone Mass Measurements Coverage Information Noridian Administrative Services (NAS), LLC, is providing coverage information regarding Bone Mass Measurements (BMM) in response to multiple provider inquiries.
DEFINITION OF OSTEOPOROSIS
CHAPTER 27 OSTEOPOROSIS AND OSTEOMALACIA DEFINITION OF OSTEOPOROSIS THE EPIDEMIOLOGY AND CONSEQUENCES OF OSTEOPOROSIS REVIEW OF BONE REMODELING BONE LOSS PATHOGENESIS OF OSTEOPOROSIS DIAGNOSIS OF OSTEOPOROSIS
Osteoporosis. The inside looks like honeycomb, with blood vessels and bone marrow in the spaces between bone.
Osteoporosis The bones in our skeleton are made of a thick outer shell and a strong inner mesh filled with collagen (protein), calcium salts and other minerals. Osteoporosis The inside looks like honeycomb,
Osteoporosis Update. Laura E. Ryan, MD
Osteoporosis Update Laura E. Ryan, MD Assistant Director for Special Programs Center for Women s Health Clinical Assistant Professor of Medicine Division of Endocrinology, Diabetes and Metabolism The Ohio
Osteoporosis in elderly: prevention and treatment
Clin Geriatr Med 18 (2002) 529 555 Osteoporosis in elderly: prevention and treatment Manish Srivastava, MD a, Chad Deal, MD b, * a Section of Geriatric Medicine, A91 Cleveland Clinic Foundation, 9500 Euclid
Margaret French, Specialist Nurse, Fracture Liaison Service Glasgow Royal Infirmary Rachel Lewis Rheumatology Specialist Physiotherapist, North
Margaret French, Specialist Nurse, Fracture Liaison Service Glasgow Royal Infirmary Rachel Lewis Rheumatology Specialist Physiotherapist, North Bristol NHS Trust Very informal workshop to facilitate discussion
2-1. Osteoporose. Dr. P. Van Wettere Radiologie en medische beeldvorming
2-1 Osteoporose Dr. P. Van Wettere Radiologie en medische beeldvorming 2-2 Osteoporose Definitie Incidentie, mortaliteit, morbiditeit, kost Diagnose Radiologie Botdensitometrie FRAX FractureCascade History
Denosumab (Prolia) for postmenopausal osteoporosis
Denosumab (Prolia) for postmenopausal osteoporosis This Medicine Update is for women who are using, or thinking about using, denosumab. Summary Denosumab is a new medicine for women with osteoporosis.
Osteoporosis Medications
Osteoporosis Medications When does a doctor prescribe osteoporosis medications? Healthcare providers look at several pieces of information before prescribing a bone- preserving or bone- building medication.
BONE MINERAL DENSITOMETRY REPORTING
CAR TECHNICAL STANDARDS FOR BONE MINERAL DENSITOMETRY REPORTING APPROVED: JANUARY 25, 2013 KERRY SIMINOSKI, MD, FRCPC; MARGARET O'KEEFFE, MD, FRCPC; JACQUES P. BROWN, MD, FRCPC; STEVEN BURRELL, MD, FRCPC;
Osteoporosis and Vertebral Compression (Spinal) Fractures Fact Sheet
Osteoporosis and Vertebral Compression (Spinal) Fractures Fact Sheet About Osteoporosis Osteoporosis is estimated to affect 200 million women worldwide. 1 Worldwide, osteoporosis causes more than nine
visualized. The correct level is then identified again. With the use of a microscope and
SURGERY FOR SPINAL STENOSIS Laminectomy A one inch (or longer for extensive stenosis) incision is made in the middle of the back over the effected region of the spine. The muscles over the bone are moved
Treatment of osteoporosis in fragility fractures
Orthogeriatrics Clinical Summary Document Treatment of osteoporosis in fragility fractures Fragility fractures are extremely prevalent in older adults with a staggering cost of treatment. As the population
Treatment of Myeloma Bone Disease
Treatment of Myeloma Bone Disease James R. Berenson, MD Medical & Scientific Director Institute for Bone Cancer & Myeloma Research West Hollywood, CA Clinical Consequences of Myeloma Bone Disease Pathological
What You Need to Know for Better Bone Health
What You Need to Know for Better Bone Health A quick lesson about bones: Why healthy bones matter The healthier your bones The more active you can be Bone health has a major effect on your quality of life
Osteoporosis Treatment Guide
Osteoporosis Treatment Guide An estimated 10 million Americans have osteoporosis. Another 34 million have low bone mass. If left untreated, osteoporosis can be both debilitating and painful. Fortunately,
Low Back Pain (LBP) Prevalence. Low Back Pain (LBP) Prevalence. Lumbar Fusion: Where is the Evidence?
15 th Annual Cleveland Clinic Pain Management Symposium Sarasota, Florida Lumbar Fusion: Where is the Evidence? Gordon R. Bell, M.D. Director, Cleveland Clinic Low Back Pain (LBP) Prevalence Lifetime prevalence:
TABLE OF CONTENTS. Surgical Technique 2. Indications 4. Product Information 5. 1. Patient Positioning and Approach 2
Surgical Technique TABLE OF CONTENTS Surgical Technique 2 1. Patient Positioning and Approach 2 2. Intervertebral Device Implanted 2 3. Buttress Plate Selection 2 4. Awl Insertion 2 5. Screw Insertion
Complications in Adult Deformity Surgery
Complications in Adult Deformity Surgery Proximal Junctional Kyphosis: Thoracolumbar and Cervicothoracic Sigurd Berven, MD Professor in Residence UC San Francisco Disclosures Research/Institutional Support:
Requests. Who requests a DXA scan? DXA. DXA Technology. Adequate Clinical Information
Requests Define a protocol for validation and prioritisation of densitometry requests. Registered medical practitioners In writing Include adequate clinical information Unsuitable requests should be discussed
Bone Basics National Osteoporosis Foundation 2013
When you have osteoporosis, your bones become weak and are more likely to break (fracture). You can have osteoporosis without any symptoms. Because it can be prevented and treated, an early diagnosis is
Osteoporosis. Dr Gordon MacDonald BSc MB BChir MRCP Consultant Rheumatologist. Rheumatology and Arthritis Seminar Tuesday 5 th February 2013
Osteoporosis Dr Gordon MacDonald BSc MB BChir MRCP Consultant Rheumatologist Rheumatology and Arthritis Seminar Tuesday 5 th February 2013 Plan What is osteoporosis? Consequences of osteoporosis Risk factors
Scans and tests and osteoporosis
Scans and tests and osteoporosis What is osteoporosis? Osteoporosis occurs when the struts which make up the mesh-like structure within bones become thin causing them to become fragile and break easily,
Prolia 2 shots a year proven to help strengthen bones.
Ask your doctor if Prolia (denosumab) is right for you and visit us at www.prolia.com For women with postmenopausal osteoporosis at high risk for fracture: there s Prolia. Prolia 2 shots a year proven
Bone Markers in Osteoporosis: Prediction of Fractures & Treatment Monitoring
Bone Markers in Osteoporosis: Prediction of Fractures & Treatment Monitoring Richard Eastell, MD FRCP FRCPath FMedSci, Professor of Bone Metabolism, University of Sheffield, Sheffield, UK Usefulness of
NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Bariatric Surgery And Skeletal Health CE APPLICATION FORM
NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Bariatric Surgery And Skeletal Health CE APPLICATION FORM First Name: Last Name: Mailing Address: City: State: Zip/Postal Code: Country: Phone
Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada: Background and Technical Report
Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada: Background and Technical Report Authors: Alexandra Papaioannou MD MSc 1, Suzanne Morin MD MSc 2, Angela M. Cheung
SIGMA sums it up: Answers to questions about osteoporosis and denosumab therapy
SIGMA sums it up: Answers to questions about osteoporosis and denosumab therapy Table of contents Who is SIGMA? Frequently asked questions we will address: 1. What is osteoporosis? 2. Why is it important
Osteoporosis Treatments That Help Prevent Broken Bones. A Guide for Women After Menopause
Osteoporosis Treatments That Help Prevent Broken Bones A Guide for Women After Menopause June 2008 fast facts Medicines for osteoporosis (OSS-tee-oh-puh-ROW-sis) can lower your chance of breaking a bone.
Clinical guideline for the prevention and treatment of osteoporosis in postmenopausal women and older men
Clinical guideline for the prevention and treatment of osteoporosis in postmenopausal women and older men February 2010 Approved by NHMRC on 5 February 2010 The Royal Australian College of General Practitioners,
Osteoporosis Diagnosis: BMD, FRAX and Assessment of Secondary Osteoporosis. Disclosure and Conflicts of Interest Steven T Harris MD 2014-2015
Osteoporosis Diagnosis: BMD, FRAX and Assessment of Secondary Osteoporosis Steven T Harris MD FACP Clinical Professor of Medicine University of California, San Francisco steve.harris@ucsf.edu Disclosure
Osteoporosis. Drugs to prevent bone fractures in people with: Contents. 2: Our Recommendations. 3: Welcome. 6: Who Needs Drugs to Prevent Fractures?
Drugs to prevent bone fractures in people with: Osteoporosis Comparing Effectiveness, Safety, and Price Contents 2: Our Recommendations 3: Welcome 6: Who Needs Drugs to Prevent Fractures? 8: Choosing a
Bone Disease in Myeloma
Bone Disease in Myeloma Washington, DC August 8, 2009 Brian G.M. Durie, M.D. Bone Disease in Myeloma Lytic Lesions Spike Bone Marrow Plasma Cells Collapse of Vertebrae Biology of Myeloma Vascular Cytokines
OSTEOPOROSIS REHABILITATION PROGRAM
OSTEOPOROSIS REHABILITATION PROGRAM Tricia Orme, R.N. BSc(N) Mary Pack Arthritis Program Victoria i Arthritis i Centre Objectives Participants will gain an understanding of what Osteoporosis is and how
Does the pain radiating down your legs, buttocks or lower back prevent you from walking long distances?
Does the pain radiating down your legs, buttocks or lower back prevent you from walking long distances? Do you experience weakness, tingling, numbness, stiffness, or cramping in your legs, buttocks or
Measure Title X RAY PRIOR TO MRI OR CAT SCAN IN THE EVAULATION OF LOWER BACK PAIN Disease State Back pain Indicator Classification Utilization
Client HMSA: PQSR 2009 Measure Title X RAY PRIOR TO MRI OR CAT SCAN IN THE EVAULATION OF LOWER BACK PAIN Disease State Back pain Indicator Classification Utilization Strength of Recommendation Organizations
SUMMARY OF THE RISK MANAGEMENT PLAN (by medicinal product)
PART VI SUMMARY OF THE RISK MANAGEMENT PLAN (by medicinal product) Format and content of the summary of the RMP The summary of the RMP part VI contains information based on RMP modules SI, SVIII and RMP
Minimally Invasive Spine Surgery For Your Patients
Minimally Invasive Spine Surgery For Your Patients Lukas P. Zebala, M.D. Assistant Professor Orthopaedic and Neurological Spine Surgery Department of Orthopaedic Surgery Washington University School of
American College of Rheumatology 2010 Recommendations for the Prevention and Treatment of
merican ollege of Rheumatology 2 Recommendations for the Prevention and Treatment of G L U O O R T I O I D - I N D U E D O S T E O P O R O S I S L I N I I N S G U I D E The objective of this guide is to
Osteoporosis Clinical guideline for prevention and treatment
Osteoporosis Clinical guideline for prevention and treatment Executive Summary Updated November 2014 National Osteoporosis Guideline Group on behalf of the Bone Research Society, British Geriatrics Society,
1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or
1 REVISOR 5223.0070 5223.0070 MUSCULOSKELETAL SCHEDULE; BACK. Subpart 1. Lumbar spine. The spine rating is inclusive of leg symptoms except for gross motor weakness, bladder or bowel dysfunction, or sexual
Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF).
Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF). Understanding your spine Disc Between each pair of vertebrae there is a disc that acts as a cushion to protect the vertebra, allows
Case Series on Chronic Whiplash Related Neck Pain Treated with Intraarticular Zygapophysial Joint Regeneration Injection Therapy
Pain Physician 2007; 10:313-318 ISSN 1533-3159 Case Series Case Series on Chronic Whiplash Related Neck Pain Treated with Intraarticular Zygapophysial Joint Regeneration Injection Therapy R. Allen Hooper
A study to Evaluate PPI s effect on vitamin D levels. Rani Hanna M.D., M.S. PGY-3 Joseph Grisanti, MD
A study to Evaluate PPI s effect on vitamin D levels Rani Hanna M.D., M.S. PGY-3 Joseph Grisanti, MD The sunshine vitamin Existed over 500 million years. Prehormone, not only a vitamin. Two major sources:
Adult Spine Rotation Specific Evaluation Orthopaedic Surgery Training Program School of Medicine, Queen s University
Adult Spine Rotation Specific Evaluation Orthopaedic Surgery Training Program School of Medicine, Queen s University CanMEDS Roles / Competencies Name: PGY Rotation Dates: s s Exceeds N/A Attending Staff:
Us TOO University Presents: Estrogen Deficiency Side Effects Due to Androgen Deprivation Therapy
Us TOO University Presents: Estrogen Deficiency Side Effects Due to Androgen Deprivation Therapy Today s speaker is Samir Taneja, MD Program moderator is Pam Barrett, Us TOO International Made possible
Steroid-Induced Osteoporosis: First, Do No Harm. Karen E. Hansen, M.D. Assistant Professor of Medicine Rheumatology Section University of WI
Steroid-Induced Osteoporosis: First, Do No Harm Karen E. Hansen, M.D. Assistant Professor of Medicine Rheumatology Section University of WI This CME program is sponsored by an unrestricted educational
STATE OF WEST VIRGINIA SUPREME COURT OF APPEALS MEMORANDUM DECISION
STATE OF WEST VIRGINIA GARY E. GOSNELL, Claimant Below, Petitioner SUPREME COURT OF APPEALS FILED March 27, 2015 RORY L. PERRY II, CLERK SUPREME COURT OF APPEALS OF WEST VIRGINIA vs.) No. 14-0614 (BOR
Cost Effectiveness Estimate of Bazedoxifene
Article ID: WMC002547 2046-1690 Cost Effectiveness Estimate of Bazedoxifene Corresponding Author: Dr. Ana A Iglesias, pharmacist, Pharmacy Department - Hospital of Manacor - Spain Submitting Author: Dr.
How To Treat Osteoporosis
Treatment Guidelines for Osteoporosis in Adults. Background Osteoporosis is a condition characterised by a reduction in bone mass density increasing the risk of fracture. Fractures occur most commonly
Update to the Treatment of Degenerative Cervical Disc Disease
Update to the Treatment of Degenerative Cervical Disc Disease Michael Lynn, MD Neurosurgeon, Southeastern Neurosurgical & Spine Institute Adjunct Assistant Clinical Professor of Bioengineering, Clemson
SYNOPSIS. Risperidone: Clinical Study Report CR003274
SYNOPSIS Protocol No: CR003274 Title of Study: An Open-Label, Long-Term Trial of Risperidone Long-Acting Microspheres in the Treatment of Subjects Diagnosed with Schizophrenia Coordinating Investigator:
Bone Disease in Myeloma. St. Petersburg, Russia September 16, 2009
Bone Disease in Myeloma St. Petersburg, Russia September 16, 2009 Bi Brian G.M. GMDurie, M.D. MD Bone Disease in Myeloma Lytic Lesions Spike Bone Marrow Plasma Cells Collapse of Vertebrae Biology of Myeloma
Hormone Replacement Therapy : The New Debate. Susan T. Hingle, M.D.
Hormone Replacement Therapy : The New Debate Susan T. Hingle, M.D. Background Hormone replacement therapy (HRT) is extensively used in the United States, especially for: *treatment of menopausal symptoms
16. ARTHRITIS, OSTEOPOROSIS, AND CHRONIC BACK CONDITIONS
16. ARTHRITIS, OSTEOPOROSIS, AND CHRONIC BACK CONDITIONS Goal Reduce the impact of several major musculoskeletal conditions by reducing the occurrence, impairment, functional limitations, and limitation
The goals of modern spinal surgery are to maximize
SPRING 2013 Robot-Guided Spine Surgery Christopher R. Good, M.D., F.A.C.S. and Blair K. Snyder, P.A.-C. The goals of modern spinal surgery are to maximize patient function and accelerate a return to a
Thomas de los Reyes PGY 1 Department of Urologic Sciences University of British Columbia. Meet Mr. S
Thomas de los Reyes PGY 1 Department of Urologic Sciences University of British Columbia Meet Mr. S 74 M admitted for back pain X-ray: sclerotic lesions along spine PSA 800 Nuclear Medicine Bone Scan 1
The Effect of Alendronate on the Age-Specific Incidence of Symptomatic Osteoporotic. Fractures. Maastricht 6
Revised Manuscript The Effect of Alendronate on the Age-Specific Incidence of Symptomatic Osteoporotic Fractures Marc C. Hochberg 1, Desmond E. Thompson 2, Dennis M. Black 3, Sara A. Quandt 4, Jane Cauley
Vibration Therapy and Osteoporosis
Vibration Therapy and Osteoporosis What is osteoporosis? Osteoporosis literally means porous bones. It occurs when the struts which make up the mesh like structure within bones become thin, causing bones
Objectives. Spinal Fractures: Classification Diagnosis and Treatment. Level of Fracture. Neuro exam Muscle Grading
Objectives Spinal Fractures: Classification Diagnosis and Treatment Johannes Bernbeck,, MD Review and apply the understanding of incidence and etiology of VCF. Examine conservative and operative management
Objectives. Osteoporosis a major public health threat. Bone-Up on Osteoporosis Update 2011
Bone-Up on Osteoporosis Update 2011 3/30/11 Kristine Olson, MS, APN, FNP-BC Nurse Practitioner Mercer Bucks Hematology Oncology 1 Objectives Review risk factors and screening for osteoporosis. Describe
Sample Treatment Protocol
Sample Treatment Protocol 1 Adults with acute episode of LBP Definition: Acute episode Back pain lasting
CMAJ JAMC. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada
CANADIAN M EDICAL A SSOCIATION J OURNAL J OURNAL DE L ASSOCIATION MÉDICALE CANADIENNE CMAJ JAMC 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada CMAJ 2002;167(10
Presented by: Nicole Nisly, MD
Presented by: Nicole Nisly, MD About Today s Presentation I will discuss osteoporosis and focus on causes, treatment op;ons and preven;on I will discuss medica;ons and life style choices that can be of
BISPHOSPHONATE RELATED OSTEONECROSIS OF THE JAW (BRONJ) BISPHOSPHONATES AND WHAT HAPPENS TO BONE VINCENT E. DIFABIO, DDS, MS MEMBER OF THE COMMITTEE ON HEALTHCARE AND ADVOCACY FROM THE AMERICAN ASSOCIATION
.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description
Fractures of the Thoracic and Lumbar Spine Page ( 1 ) Spinal fractures can vary widely in severity. While some fractures are very serious injuries that require emergency treatment, other fractures can
SPINAL FUSION. North American Spine Society Public Education Series
SPINAL FUSION North American Spine Society Public Education Series WHAT IS SPINAL FUSION? The spine is made up of a series of bones called vertebrae ; between each vertebra are strong connective tissues
Treating Bulging Discs & Sciatica. Alexander Ching, MD
Treating Bulging Discs & Sciatica Alexander Ching, MD Disclosures Depuy Spine Teaching and courses K2 Spine Complex Spine Study Group Disclosures Take 2 I am a spine surgeon I like spine surgery I believe
Venous Thromboembolism: Long Term Anticoagulation. Dan Johnson, Pharm.D.
Venous Thromboembolism: Long Term Anticoagulation Dan Johnson, Pharm.D. Disclosures No financial relationships with products discussed Off-label use of drug therapy always discussed Objectives Review clinical
2.0 Synopsis. Vicodin CR (ABT-712) M05-765 Clinical Study Report R&D/07/095. (For National Authority Use Only) to Part of Dossier: Volume:
2.0 Synopsis Abbott Laboratories Name of Study Drug: Vicodin CR Name of Active Ingredient: Hydrocodone/Acetaminophen Extended Release (ABT-712) Individual Study Table Referring to Part of Dossier: Volume: