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01-09-2018 | Review Article

The Global Spine Care Initiative: a review of reviews and recommendations for the non-invasive management of acute osteoporotic vertebral compression fracture pain in low- and middle-income communities

Authors: Arthur Ameis, Kristi Randhawa, Hainan Yu, Pierre Côté, Scott Haldeman, Roger Chou, Eric L. Hurwitz, Margareta Nordin, Jessica J. Wong, Heather M. Shearer, Anne Taylor-Vaisey

Published in: European Spine Journal | Special Issue 6/2018

Abstract

Purpose

The purpose of this review was to develop recommendations for non-invasive management of pain due to osteoporotic vertebral compression fractures (OVCF) that could be applied in medically underserved areas and low- and middle-income countries.

Methods

We conducted a systematic review and best evidence synthesis of systematic reviews on the non-invasive management of OVCF. Eligible reviews were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. Low risk of bias systematic reviews and high-quality primary studies that were identified in the reviews were used to develop recommendations.

Results

From 6 low risk of bias systematic reviews and 14 high-quality primary studies we established that for acute pain management, in addition to rest and analgesic medication, orthoses may provide temporary pain relief, in addition to early mobilization. Calcitonin can be considered as a supplement to analgesics; however, cost is of concern. Once acute pain control is achieved, exercise can be effective for improving function and quality of life.

Conclusion

The findings from this study will help to inform the GSCI care pathway and model of care for use in medically underserved areas and low- and middle-income countries. Conservative management of acute pain and recovery of function in adults with OVCF should include early mobilization, exercise, spinal orthosis for pain relief, and calcitonin for analgesic-refractory acute pain.

Graphical Abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: The Global Spine Care Initiative: a review of reviews and recommendations for the non-invasive management of acute osteoporotic vertebral compression fracture pain in low- and middle-income communities
Authors: Arthur Ameis
Kristi Randhawa
Hainan Yu
Pierre Côté
Scott Haldeman
Roger Chou
Eric L. Hurwitz
Margareta Nordin
Jessica J. Wong
Heather M. Shearer
Anne Taylor-Vaisey
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue Special Issue 6/2018
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-5273-6

At a glance: The STEP trials

Springer Medicine

The Global Spine Care Initiative: a review of reviews and recommendations for the non-invasive management of acute osteoporotic vertebral compression fracture pain in low- and middle-income communities

Abstract

Purpose

Methods

Results

Conclusion

Graphical Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Graphical Abstract

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