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Bisphosphonates are not associated with vertebral osteonecrosis
David F Kallmes1, Arash Ehteshami Rad, Leigh A Gray
1Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA. kallmes.david@mayo.edu
Journal of Bone and Mineral Metabolism
|March 28, 2009
Summary
Intravertebral clefts, markers for osteonecrosis, were not associated with bisphosphonate therapy in this study. This suggests bisphosphonate use does not increase the risk of vertebral osteonecrosis.
Area of Science:
- Orthopedics
- Pharmacology
- Radiology
Background:
- Intravertebral clefts are recognized indicators of vertebral osteonecrosis.
- Bisphosphonates are commonly prescribed for osteoporosis and other bone conditions.
- The potential link between bisphosphonate therapy and vertebral osteonecrosis requires investigation.
Purpose of the Study:
- To investigate the association between bisphosphonate therapy and the presence of intravertebral clefts.
- To determine if bisphosphonate exposure or duration correlates with vertebral osteonecrosis markers.
Main Methods:
- Retrospective review of a vertebroplasty database.
- Documentation of bisphosphonate exposure, duration, and type.
- Radiographic identification of intravertebral clefts (markers for osteonecrosis).
- Statistical comparison (Chi-squared and Student's t-tests) between bisphosphonate-exposed and unexposed groups.
Main Results:
- Out of 237 patients, 67 (28%) received bisphosphonate therapy.
- Intravertebral clefts were present in 29% of all patients.
- No significant difference in cleft prevalence was found between bisphosphonate users (22%) and non-users (31%) (P=0.17).
- Mean duration of bisphosphonate therapy was similar in patients with and without clefts (P=0.80).
Conclusions:
- Intravertebral clefts were not statistically associated with bisphosphonate therapy.
- The findings suggest bisphosphonate therapy is not linked to an increased risk of vertebral osteonecrosis.
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