Teriparatide may encourage spine fusion, heal fractures in osteoporosis
LAS VEGAS — Injections of teriparatide could encourage bony healing and fusion in the spine and prevent future fractures in patients with osteoporosis, according to research presented at the AACE 23rd Annual Scientific & Clinical Congress.
“The use of teriparatide appears to be an effective option for our patients who are at increased risk for pseudoarthroses or who have sustained fractures and elect to be treated conservatively,” Elaina Barraza, RN, of SpineCal in Santa Monica, Cal., said during her presentation.
Barraza and Pablo Pazmino, MD, reviewed radiographs of 18 patients with documented osteoporosis before and after a minimum of 12 months of daily teriparatide (Forteo, Eli Lilly) treatment. Patients were separated into cohorts: surgical fusions that appeared to be progressing slowly at least 3 months after the procedure (group 1, n=12) and spinal fractures treated without surgery (group 2, n=6).
The researchers followed up with all patients at 3 weeks, 6 weeks, 3 months, 6 months and 1 year, using radiographs and CT scans to confirm final bony fusion; they also measured post treatment pain, visual analogue scale and quality of life.
In group 1, radiographic fusion and bony cortico-cancellous bridging were evaluated on postoperative CT scans. In group 2, kyphosis and wedge angle of the fractured vertebral body were measured. The researchers also examined ratios of anterior, middle and posterior heights of the fractured body to posterior height of the normal adjacent level vertebrae in order to obtain the degree of adjacent level collapse or asymptomatic progression of osteoporosis.
Progression of spinal cortical and cancellous fusion was observed in 100% of group 1. At 1 year, mean increments of kyphosis and wedge angle were unchanged in group 2 (6.3 and 5.3 degrees, respectively) and in adjacent level vertebral bodies. Improved bone mineral densities were seen in both groups following treatment.
“Our patients experienced rapid improvement and return to functional status, work and exercise, and these findings have been sustained,” Barraza said.
For more information: Pazmino P. Abstract 600. Presented at: AACE 23rd Annual Scientific & Clinical Congress; May 13-18, 2014; Las Vegas, Nevada.
Disclosures: Pazmino is an OsteoMed Consultant. Barraza has no financial disclosures to report.