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Targeted exercise program can reduce osteoporotic refracture risk after percutaneous vertebroplasty

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Patients treated with percutaneous vertebroplasty who participated in a targeted exercise program after surgery showed a significantly lower risk of refracture compared to patients treated with percutaneous vertebroplasty alone, a retrospective study found.

Elizabeth A. Huntoon, MD, and colleagues at the Mayo Clinic in Rochester, Minn., investigated whether participating in the Rehabilitation of Osteoporosis Program-Exercise (ROPE) instruction, which includes back-strengthening exercises, could reduce the rate of osteoporotic fracture recurrence, or delay the time to refracture.

The researchers reviewed data for 507 patients with osteoporosis treated with percutaneous vertebroplasty (PVP) from July 1998 through August 2005. Investigators excluded patients who had evidence of secondary osteoporosis or traumatic vertebral compression fractures, as well as those who were using long-term oral corticosteroids or had bone malignancies.

The final data analysis included 57 patients aged 55 years and older who had at least one radiographically confirmed nontraumatic vertebral compression fracture, according to the study, published in Mayo Clinic Proceedings.

Investigators categorized the remaining 57 patients into three groups according to treatment. Twenty patients received ROPE only, 20 patients received PVP only and 17 patients received both PVP and ROPE.

"The end point was the refracture date or date of the last recorded follow-up if no refracture occurred," the researchers wrote.

The investigators found that refractures occurred after an average of 4.5 months among patients in the PVP group, after 60.4 months in patients treated with ROPE only, and after 20.4 months among patients treated with both PVP and ROPE (P < .001).

"This retrospective study showed that a targeted exercise program after PVP significantly decreased fracture recurrence. Refracture rates also were lower in the ROPE-only group vs the PVP-only group," the study authors wrote.

For more information:

• Huntoon EA, Schmidt CK, Sinaki M. Significantly fewer refractures after vertebroplasty in patients who engage in back-extensor-strengthening exercises. Mayo Clin Proc. 2008;83:54-57.