Efficacy And Safety Of Vertebroplasty For Treatment Of Painful Osteoporotic Spinal Fractures: A Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$586,250.00
Summary
Painful spinal or vertebral fractures are a substantial and growing public health problem and are a burden on the health care system. In Australia, 20-25% of women and 15-20% of men over the age of 50 will develop one or more fractures of their spine in their lifetime. Up to a half of these fractures will result in severe pain and disability. While the fractures generally heal within weeks or a few months, some are so painful that they require narcotic pain control, hospitalisation, and-or long- ....Painful spinal or vertebral fractures are a substantial and growing public health problem and are a burden on the health care system. In Australia, 20-25% of women and 15-20% of men over the age of 50 will develop one or more fractures of their spine in their lifetime. Up to a half of these fractures will result in severe pain and disability. While the fractures generally heal within weeks or a few months, some are so painful that they require narcotic pain control, hospitalisation, and-or long-term nursing home care. Other problems include chronic pain, spinal deformities, loss of height and mobility and restricted breathing. Vertebroplasty is a new procedure consisting of injection of a type of 'bone cement' into the vertebrae to mend the break. It is an exciting treatment because for some people, this results in an immediate and sustained improvement in pain. Although rare, complications such as rib fracture, cement leakage and fractures in other vertebrae do occur. One particular concern is that the mechanical changes to the spine caused by the bone cement may cause long-term complications such as an increased risk of future fractures of treated or adjacent vertebrae. So far, there is very little evidence of the efficacy and safety of this new technology. Importantly, it has not been compared with usual medical care for fractures. In medical research it can be difficult to properly evaluate an exciting and 'apparently' effective treatment that doctors and patients demand. The main aim of this project is to determine whether vertebroplasty is an effective and safe treatment compared to usual medical care. We have a unique opportunity to evaluate vertebroplasty through a strong collaborative effort between the 3 centres currently offering this procedure in Melbourne. If vertebroplasty can be demonstrated to be an effective, safe and cost-effective treatment for painful osteoporotic spinal fractures this will be a valuable addition to current treatment options.Read moreRead less
Multidisciplinary Management Of Vertebral Metastases Identification Of Standardized Surgical Guidelines
Funder
National Health and Medical Research Council
Funding Amount
$358,604.00
Summary
The spine is the commonest site of cancer spread to the skeleton and often leads to severe pain and paralysis. Recent advances in surgical techniques enable removal and reconstruction of all tumours of the spine. However, surgery remains controversial because of the need to weigh up the patient’s estimated length of survival with the risks of surgery. Our aims are to develop clear guidelines on which patients to perform surgery on, and what type of surgery to perform.
Effects Of Vitamin D And Calcium On Bone Strength, Balance And Falls In Elderly Women
Funder
National Health and Medical Research Council
Funding Amount
$230,900.00
Summary
Many osteoporotic fractures occur as a result of bone fragility and falls. Both falls and fractures are huge public health problems in Australia. Falls are the leading cause of injury-related hospitalization and death in person older than 65 years of age. During 1996 almost 36,000 people attended a hospital after a fall and 5% of these resulted in fracturing a bone. The incidence of fall-related hospital admission increases exponentially with age, reaching 4% per annum for men and 7% per annum f ....Many osteoporotic fractures occur as a result of bone fragility and falls. Both falls and fractures are huge public health problems in Australia. Falls are the leading cause of injury-related hospitalization and death in person older than 65 years of age. During 1996 almost 36,000 people attended a hospital after a fall and 5% of these resulted in fracturing a bone. The incidence of fall-related hospital admission increases exponentially with age, reaching 4% per annum for men and 7% per annum for women aged 85 years and older. In the community approximately one third of older people fall each year. Compared to men, women are three times more likely to be hospitalized or one and half times more likely to die from a fall-related injury. Importantly women have an increased risk of fracture and over 40% of women over the age of 50 will break a bone. Previous European and American studies suggest that calcium replacement may improve bone strength while vitamin D may reduce falls. However, the separation of these two effects has never been studied. We have previously studied elderly falling women who attended the Emergency Department of large teaching hospitals in Perth and have shown that many are calcium and vitamin D deficient. We are undertaking a short term randomized controlled trial of calcium alone or calcium with vitamin D, to study the effects on bone strength as measured non-invasively, balance and falls in this high risk group of subjects. We have already recruited 100 subjects and six subjects have completed their 6 months assessment. We plan to recruit the remaining 200 subjects during the following 12 months and give all subjects one year of treatment. At the end of this study we should be able to offer clear treatment guidelines for this high risk group of patients.Read moreRead less
Does An Annual High Dose Vitamin D Supplement Decrease Healthcare Utilisation In Older Women?
Funder
National Health and Medical Research Council
Funding Amount
$104,995.00
Summary
The shorter bleaker days of winter can cause a vitamin D deficiency in Australian women, increasing their risk of osteoporosis and broken bones including hip fracture. New research suggests that the low winter levels of the vitamin may not be good for us in many ways and the NHMRC is funding a Geelong-based study to determine if Austrlia's elderly can improve their overall health by taking a once-a-year dose of vitamin D tablets.
Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perfo ....Fractures, in particular femoral neck (FN) fractures, are a huge public health problem resulting in disabilities, mortality and financial cost to the community. The prevention of these fractures is based on estimation of bone strength. The decision whether someone needs treatment, or the effectiveness of a treatment can only be judged by estimating bone strength. The bottom line is that currently we cannot correctly estimate bone strength. Present methods such as bone mineral density (BMD) perform poorly. Most people who fracture are not detected by BMD because their BMD is either normal or high, and many people with low BMD never fracture. The main aim of this grant application is to develop new tools to allow doctors and scientists worldwide to better estimate FN strength. To develop new methods to replace BMD, scientists need to make use of the 3D aspects of the bone such as size, shape and internal architecture. Presently, these 3D aspects (structure) have not been adequately studied and scientists incorrectly approximate them. As a result new methods are not any better. A good quantification of structure is needed. Another reason for the failure to accurately estimate the strength of bones is that estimates are based on a single parameter whereas the bone, like any architectural structure (e.g. building), comprises many components acting together to maintain its strength. To determine the strength based on density alone is incorrect; the size, the shape and things inside the structure need to be considered as a whole. After quantifying correctly the structure and components of bone strength, we will determine how they can be used individually and together to better estimate the strength of the FN in men and women. Tools generated will be used to better determine people likely to fracture and needing treatment; to better tailor and monitor treatments. A better understanding of the causes and epidemiology of fractures will ensue.Read moreRead less