Issue link: https://beckershealthcare.uberflip.com/i/1120168
26 Executive Briefing findings, along with several other consensus statements, in The Spine Journal. The personalized treatment plan may also call for one of two minimally invasive procedures, either vertebroplasty or balloon kyphoplasty. Prospective, randomized, controlled studies have shown less pain and improved quality of life when compared with non- surgical management. 7 To establish its clinical pathway, the panel of clinicians examined 576 clinical scenarios. The group determined 46 percent of the cases were appropriate for vertebral augmentation and 16 percent were appropriate for non-surgical management. 8 "Multiple clinical studies and claims data analysis have demonstrated that patients who receive balloon kyphoplasty or vertebroplasty over non- surgical management not only experienced pain relief, but also enjoyed improved function, mobility and quality of life," said Jeff Cambra, vice president and general manager of Medtronic's interventional pain therapies – restorative therapies group. "Furthermore, BKP has been clinically shown to reduce prescription opioids. 9 In addition to recommending patients with severe pain and a confirmed probability of VFF undergo advanced imaging with MRI, CT scan or bone scan, the panel also came to consensus about appropriate treatment and follow-up protocol. The physicians suggested a shorter period of time than clinicians traditionally wait before pursuing more aggressive treatment options like interventional care. Clinicians historically followed undefined and non-standardized pathways that included physical therapy and other conservative management before moving forward to more aggressive intervention. However, the panel found experts believed patients could potentially benefit from earlier surgical intervention. The panel recommended all VFF patients: • Be referred to bone density and osteoporosis education • Take part in an osteoporosis prevention and treatment program • Receive repeat imaging if symptoms are not resolved at the follow-up visit When patients continue to experience pain and present symptoms, the physician and patient may consider minimally invasive procedures. "It's important to have a timely diagnosis and treatment for VFF patients because fractures continue to collapse," Dr. Andreshak said. "The vertebral compression fractures have been historically considered stable, but they continue to compress further until patients have a deformity. By treating it expeditiously, our goal is to avoid complications and risk." Jeff Cambra Vice President, General Manager Interventional Pain Therapies Medtronic Reprinted from The Spine Journal 2018, Hirsch J., Beall D., Chambers M., et al. Management of Vertebral Fragility Fractures (VCF): A clinical care pathway developed by a multispecialty panel using the RAND™/UCLA Appropriateness Method, Copyright 2018 with permission from Elsevier.