The extent of diagnosis and treatment of osteoporosis in a Veterans Affairs population undergoing vertebral augmentation.
OBJECTIVE
To investigate whether patients with vertebral fracture who underwent an augmentation procedure had pre- or postaugmentation osteoporosis evaluation and treatment.


METHODS
Retrospective chart review.


METHODS
An academic, tertiary Veterans Affairs Medical Center with an active osteoporosis program, easy access to bone density testing by dual energy x-ray absorptiometry (DEXA), few barriers to treatment, and an excellent electronic medical record.


METHODS
After patients who underwent vertebroplasty for a traumatic or pathologic fracture were excluded, 40 patients were identified who had the procedure during a 1.5-year period. Most patients were older white men.


METHODS
Assessment of which patients had evaluation of underlying bone disease (with DEXA and 25-hydroxyvitamin D levels) and whether it was treated (with pharmacologic therapy).


RESULTS
About 75% had a DEXA, but only half had the DEXA before the augmentation procedure. Fifty-five percent had the diagnosis of osteoporosis or osteopenia in the electronic record, and 60% had a serum 25-hydroxyvitamin D level usually before the procedure. Those patients who were referred to a metabolic bone clinic were more likely to have diagnostic tests and therapy.


CONCLUSIONS
As with hip fracture, low-trauma vertebral fracture treated by an augmentation procedure should lead to osteoporosis evaluation and therapy.
Kasturi
Gopi
G
VA Central California Health Care System, UCSF-Fresno, Fresno, CA, USA.
Adler
Robert A
RA
D000368:Aged; D000369:Aged, 80 and over; D001596:Benzylamines; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology* / Q000601:surgery; D014481:United States; D014493:United States Department of Veterans Affairs
D001596:Benzylamines; C017951:teclozan