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WHO releases new spinal fracture risk tool

Medtronic : 20 March, 2008  (New Product)
Medtronic has saluted the World Health Organization (WHO) for releasing a fracture risk tool that validates the importance of diagnosing spinal fractures to help doctors assess proper treatment for people at high risk for developing osteoporosis and related fractures.
FRAX is a clinically based, 10-year fracture risk model developed by the WHO and Dr John A Kanis, professor emeritus at the University of Sheffield in the UK. The tool evaluates bone mineral density and nine other specific clinical risk factors to determine a person’s probability of having an osteoporosis-related fracture of the spine, forearm, hip or shoulder within 10 years.

According to the FRAX tool, a previous fracture, either occurring spontaneously or from trauma, is one of the clinical risk factors that places a person at high risk for future fractures. A prior history of clinical spinal fractures, known as vertebral compression fractures, is identified in the model as an especially strong indicator for osteoporosis and the risk of future fractures.

“The publication of this tool by the World Health Organization will create much-needed awareness of the risk factors for osteoporosis-related fractures, possibly leading to earlier diagnosis of osteoporosis and proper treatment to prevent fractures,” said Art Taylor, vice president and general manager of Medtronic’s Spinal and Biologics Business in charge of Kyphon and Interspinous Process Device product lines. “In particular, we hope that this report will generate earlier detection of existing vertebral compression fractures to help physicians better manage osteoporosis and appropriately treat spinal fractures.”

In addition to the WHO FRAX tool, a recent study published by the American Medical Association shows that a low bone mineral density reading and a previous vertebral compression fracture are independently related to new spinal fractures. In the study, ‘Long Term Risks of Vertebral Compression Fractures’ by Dr Jane A Cauley, et al, 2,680 American women were studied over a 15-year period. The study found that women with previous vertebral compression fractures have a substantially increased risk of another fracture, especially if they have osteoporosis diagnosed by a bone mineral density reading.

Guidelines for more effectively diagnosing and treating osteoporosis are becoming increasingly important because of the high cost to society and health care agencies from osteoporosis-related fractures. The cost to the US health care system in 2005 from these fractures was estimated at $17 billion. Additionally, the number of these fractures is expected to increase more than three-fold over the next 50 years with the aging population, according to the WHO.

Osteoporosis today causes more than 8.9 million hip, wrist and spinal fractures worldwide each year according to the WHO. In the USA alone, there are approximately 700,000 spinal compression fractures each year. However, an estimated two out of three go undiagnosed and untreated.

Ann Warner of Memphis, Tenn. is one patient who discovered she suffered from this often ‘silent disease’.

“I had an MRI on my back and they found I had these compressed fractures of the vertebrae,” the 77-year-old Warner said. “I had four or five fractures, some of them old, old ones. I can imagine these fractures happened over a period of time. I don’t remember being in any extreme pain at any particular time, but then again you have backaches here and backaches there.”

The ‘silent disease’ element of osteoporosis is further reason why adults at risk for this disease should seek early diagnosis, especially if they are suffering acute back pain. Under the FRAX tool, Warner’s previous fractures would have indicated a high probability of osteoporosis and subsequent fractures. If they had been diagnosed earlier, she may have received treatment for her osteoporosis.

Vertebral compression fractures can be effectively managed when diagnosed. Among several means of managing such fractures is balloon kyphoplasty, a minimally invasive procedure offered by Medtronic for spinal fractures caused by osteoporosis and cancer that corrects the angular deformity and stabilizes the fracture.

In Warner’s case, she underwent balloon kyphoplasty procedure for the repair of two vertebral compression fractures. Today she has stopped taking pain pills and is back to her active lifestyle, volunteering at her local hospital and participating in daily exercise classes at her local gym.
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