Older adults with osteoporotic spine fractures who have a poor prognosis are less likely to require surgery if they are initially prescribed two weeks of bed rest, according to a new study.
Current clinical guidelines for osteoporotic spine fracture do not recommend bed rest during treatment, chiefly due to lack of evidence. But a strict period of bed rest in the initial phase of treatment, rather than physical rehabilitation exercises, can be beneficial for the most compromised patients, found the researchers, from the University of Tsukuba in Japan.
Poor prognosis
The study, published in the Journal of Bone & Joint Surgery, followed 224 hospital patients, aged 65 years and older. Participants were assigned to one of two groups, those who were initially treated with bed rest and those who were prescribed active therapy. Some (82) had a poor prognosis for recovery based on magnetic resonance imaging of their injuries.
All participants began treatment within two weeks after their injury and were observed for six months. Investigators compared the rate of surgery, bone healing or additional bone damage and changes in ability to perform daily activities between the groups.
Fewer surgeries
Patients with a poor prognosis whose treatment included two weeks of bed rest were less likely to require surgery than those whose treatment encouraged out-of-bed rehabilitation (such as walking therapy) as soon as their pain level allowed. In addition, the strict bed-rest group also had relatively reduced progression of vertebral collapse and kyphosis (curvature of the spine), regardless of the MRI findings.
“As part of conservative treatment, a brief initial period of bed rest is as safe as no rest and has an excellent effect,” Toru Funayama, MD, PhD, said in a statement.
Related articles:
Clinicians have a wealth of drug options for tackling seniors’ spine pain, review finds
Spinal anesthesia no better than general anesthesia for hip fracture patients: study
