High-dose bisphosphonate therapy in an urgent case of spontaneous multiple vertebral fractures in a 55 year old woman.
An early postmenopausal Caucasian woman aged 55 sustained multiple vertebral fractures after a minor trauma. After exclusion of any kind of secondary osteoporosis, we administered due to clinical severity combined oral and cyclic intravenous bisphosphonate therapy (oral risedronate 35 mg/week, i.v. pamidronate 30 mg quarterly) with adequate calcium and vitamin D supplementation for 28 months. We performed a transiliac bone biopsy at baseline and at month 28. The paired samples were investigated by histomorphometry, by microCT-analysis for 3d structure and by qBEI representing bone mineral density distribution. Mineralisation of the bone matrix was not influenced by supplementation of calcium and vitamin D. Parameters of bone architecture and BMD improved; and a reduction of pain and increased mobility was observed. No further osteoporotic fractures occurred during the time of investigation.
Muschitz
Christian
C
St. Vincent Hospital, Medical Department II, Vienna, Austria. christian.muschitz@bhs.at
Roschger
Paul
P
Patsch
Janina
J
Pollhammer
Isabella
I
Koller
Bruno
B
Klaushofer
Klaus
K
Resch
Heinrich
H
D015502:Absorptiometry, Photon; D000058:Accidental Falls; D000284:Administration, Oral; D001706:Biopsy; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D001842:Bone and Bones / Q000473:pathology; D004164:Diphosphonates / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D012968:Etidronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005598:Fractures, Spontaneous; D006801:Humans; D007275:Injections, Intravenous; D008159:Lumbar Vertebrae / Q000293:injuries*; D008875:Middle Aged; D000077268:Pamidronate; D000068296:Risedronic Acid; D016103:Spinal Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D013904:Thoracic Vertebrae / Q000293:injuries*; D013997:Time Factors; D016896:Treatment Outcome
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000068296:Risedronic Acid; D012968:Etidronic Acid; D000077268:Pamidronate