A team of intrepid researchers have completed a study of 2,933 emergency room patients with vertebral fractures over a six-year time span—from 2008 to 2014. They found that a substantial percentage of those patients had NOT received a bone density scan prior to experiencing a vertebral fracture.
Their work, “Rates of osteoporosis screening and treatment following vertebral fracture,” was published in the March 2019 edition of The Spine Journal.
Co-author Jonathan J. Carmouche, M.D., Section Chief of Spine and Pediatrics for the Department of Orthopaedic Surgery at Carilion Clinic in Roanoke, Virginia and co-author, explained the purpose of the study to OTW, “We were seeing a lot of patients coming in with 3rd and 4th fractures without having been treated for osteoporosis. Many of our hip fracture patients had earlier, less severe, fractures. That left us kicking ourselves wondering what we could do better and why we weren’t doing it.”
“We found that we, as the region’s premier tertiary care center, were dropping the ball on over 90% of vertebral fracture patients. They weren’t getting DXA [bone density] scans to formally screen them for osteoporosis or diagnosed clinically and were therefore not being treated or were being under treated significantly.”
“We, as the orthopedic surgeons, need to take ownership over initiating bone health evaluations in our fragility fracture patients. We see these patients every day with fractures from poor bone quality. Instead of staying silent, we need to take action. Ideally, that means starting a medication, or better yet a fracture liaison service. At a minimum, we should be clearly communicating to both the patient and PCP [primary care physicians] that this patient has clinical osteoporosis based on the ASBMR criteria (classic osteoporotic fracture = clinical osteoporosis) and recommending that they start treatment.”
“Take a leadership role in your community in osteoporosis care. We cannot rely on PCPs to own our patients’ bone health. We have to be proactive about getting them the care they need. Put a system in place to ensure that we as orthopedists provide that service to the patients we serve.
