Osteoporotic Vertebral Fracture
Principles of Management
The BNSSG Osteoporotic Vertebral Fracture Care Pathway has been developed by Dr Jon Tobias (Consultant Rheumatologist) and Dr Verka Beric (Consultant Radiologist) for patients with suspected osteoporotic vertebral fracture.
The pathway should help GPs in managing patients with new onset back pain with confirmed vertebral fracture on x-ray. It also advises when GPs should consider referral to secondary care for consideration of vertebroplasty and/or osteoporosis specialist management.
Referrals for consideration of vertebroplasty should be directed to NBT by eReferral - Clinic details: Neurosurgery - Vertebral fracture clinic (vertebroplasty)
Consider referral to Vertebroplasty Clinic if the following conditions exist:-
1. Acute onset of back pain with or without obvious precipitating cause.
2. Fracture confirmed on x-ray.
3. Failure of conservative measures, including optimal analgesia over 6 weeks, to control pain.
The patient will be evaluated for suitability of vertebroplasty or other vertebral augmentation procedure with MRI scan and specialist assessment. If suitable for the procedure, the technique will be explained to the patient and pre-operative assessment also will be performed on the same day. The Vertebroplasty Clinic is a ‘one stop’ planning service. The vertebroplasty procedure will be performed within 2 to 4 weeks from the date of the Clinic appointment.
Referrals for secondary care osteoporosis clinics can be made to:
NBT via eRS
UHB via eRS (RAS service) - faxed referrals no longer accepted
WGH via eRS