Faculty Collaboration Database

ACR Appropriateness Criteria^® Management of Vertebral Compression Fractures. J Am Coll Radiol 2018 Nov;15(11S):S347-S364

Date

11/06/2018

Pubmed ID

30392604

DOI

10.1016/j.jacr.2018.09.019

Scopus ID

2-s2.0-85055415180 (requires institutional sign-in at Scopus site)   56 Citations

Abstract

Vertebral compression fractures (VCFs) have various causes, including osteoporosis, neoplasms, and acute trauma. As painful VCFs may contribute to general physical deconditioning, management of painful VCFs has the potential for improving quality of life and preventing superimposed medical complications. Various imaging modalities can be used to evaluate a VCF to help determine the etiology and guide intervention. The first-line treatment of painful VCFs has been nonoperative or conservative management as most VCFs show gradual improvement in pain over 2 to 12 weeks, with variable return of function. There is evidence that vertebral augmentation (VA) is associated with better pain relief and improved functional outcomes compared to conservative therapy for osteoporotic VCFs. A multidisciplinary approach is necessary for the management of painful pathologic VCFs, with management strategies including medications to affect bone turnover, radiation therapy, and interventions such as VA and percutaneous thermal ablation to alleviate symptoms. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Author List

Expert Panels on Neurological Imaging, Interventional Radiology, and Musculoskeletal Imaging:, Shah LM, Jennings JW, Kirsch CFE, Hohenwalter EJ, Beaman FD, Cassidy RC, Johnson MM, Kendi AT, Lo SS, Reitman C, Sahgal A, Scheidt MJ, Schramm K, Wessell DE, Kransdorf MJ, Lorenz JM, Bykowski J

Authors

Eric J. Hohenwalter MD, FSIR Chief, Professor in the Radiology department at Medical College of Wisconsin
Matthew J. Scheidt MD, FSIR Associate Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Diagnosis, Differential
Evidence-Based Medicine
Fractures, Compression
Humans
Pain Management
Recovery of Function
Societies, Medical
Spinal Fractures
United States