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Article ; Online: Pain in adult myotonic dystrophy type 1: relation to function and gender.

Solbakken, Gro / Løseth, Sissel / Froholdt, Anne / Eikeland, Torunn D / Nærland, Terje / Frich, Jan C / Dietrichs, Espen / Ørstavik, Kristin

BMC neurology

2021 Volume 21, Issue 1, Page(s) 101

Abstract: Background: Pain is prevalent in myotonic dystrophy 1 (DM1). This study investigated whether CTG repeat size, disease duration, BMI and motor and psychological function were related to pain in adult patients with DM1, and if there were gender ... ...

Abstract	Background: Pain is prevalent in myotonic dystrophy 1 (DM1). This study investigated whether CTG repeat size, disease duration, BMI and motor and psychological function were related to pain in adult patients with DM1, and if there were gender differences regarding intensity and location of pain. Method: Cross-sectional design. Pain was investigated in 50 genetically confirmed DM1 patients by combining clinical assessment and self-reports of pain intensity and locations. Pain scoring results were related to CTG size, disease duration, muscle strength, walking capacity measured by 6-min walk test, activity of daily life by Katz ADL Index, respiratory function by Forced Vital Capacity and BMI. In addition, the degree of reported pain was related to Quality of life measured by WHOQOL-BREF; fatigue was measured by Fatigue severity scale; psychological functions were measured by Beck Depression Inventory, Beck Anxiety Inventory, IQ and Autism spectrum Quotient. Results: Pain was reported in 84% of the patients and was significantly correlated with CTG size (r = 0.28 p = 0.050), disease duration (r = 0.38 p = 0.007), quality of life (r = - 0.37 p = 0.009), fatigue (r = 0.33 p = 0.02) and forced vital capacity (r = - 0.51, p = 0.005). Significant gender differences, with higher scores for females, were documented. In male subjects the number of pain locations was significantly correlated with quality of life and the autism quotient. In females, pain intensity was significantly correlated with activity, respiratory function and BMI. Conclusions: Pain in DM1 was prevalent, with a strong association to lung function and other aspects of the disease. Significant gender differences were present for pain intensity and number of pain locations. How pain was related to other symptoms differed between male and female subjects. Our findings highlight the importance of assessments of pain in DM1 patients.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Myotonic Dystrophy/complications ; Myotonic Dystrophy/genetics ; Pain/epidemiology ; Pain/genetics ; Prevalence ; Quality of Life ; Sex Characteristics ; Trinucleotide Repeat Expansion/genetics
Language	English
Publishing date	2021-03-04
Publishing country	England
Document type	Journal Article
ISSN	1471-2377
ISSN (online)	1471-2377
DOI	10.1186/s12883-021-02124-9
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Article ; Online: Correlation between gene expression and MRI STIR signals in patients with chronic low back pain and Modic changes indicates immune involvement.

Vigeland, Maria Dehli / Flåm, Siri Tennebø / Vigeland, Magnus Dehli / Espeland, Ansgar / Kristoffersen, Per Martin / Vetti, Nils / Wigemyr, Monica / Bråten, Lars Christian Haugli / Gjefsen, Elisabeth / Schistad, Elina Iordanova / Haugen, Anne Julsrud / Froholdt, Anne / Skouen, Jan Sture / Zwart, John-Anker / Storheim, Kjersti / Pedersen, Linda Margareth / Lie, Benedicte Alexandra

Scientific reports

2022 Volume 12, Issue 1, Page(s) 215

Abstract: Disability and distress caused by chronic low back pain (LBP) lacking clear pathoanatomical explanations cause huge problems both for patients and society. A subgroup of patients has Modic changes (MC), identifiable by MRI as vertebral bone marrow ... ...

Abstract	Disability and distress caused by chronic low back pain (LBP) lacking clear pathoanatomical explanations cause huge problems both for patients and society. A subgroup of patients has Modic changes (MC), identifiable by MRI as vertebral bone marrow lesions. The cause of such changes and their relationship to pain are not yet understood. We explored the pathobiology of these lesions using profiling of gene expression in blood, coupled with an edema-sensitive MRI technique known as short tau inversion recovery (STIR) imaging. STIR images and total RNA from blood were collected from 96 patients with chronic LBP and MC type I, the most inflammatory MC state. We found the expression of 37 genes significantly associated with STIR signal volume, ten genes with edema abundancy (a constructed combination of STIR signal volume, height, and intensity), and one gene with expression levels significantly associated with maximum STIR signal intensity. Gene sets related to interferon signaling, mitochondrial metabolism and defense response to virus were identified as significantly enriched among the upregulated genes in all three analyses. Our results point to inflammation and immunological defense as important players in MC biology in patients with chronic LBP.
MeSH term(s)	Adult ; Bone Marrow/diagnostic imaging ; Bone Marrow/immunology ; Chronic Pain/diagnostic imaging ; Chronic Pain/genetics ; Chronic Pain/immunology ; Female ; Gene Expression Profiling ; Gene Expression Regulation ; Humans ; Low Back Pain/diagnostic imaging ; Low Back Pain/genetics ; Low Back Pain/immunology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Predictive Value of Tests ; Randomized Controlled Trials as Topic ; Spine/diagnostic imaging ; Spine/immunology ; Transcriptome
Language	English
Publishing date	2022-01-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-04189-5
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Article ; Online: Amoxicillin Did Not Reduce Modic Change Edema in Patients With Chronic Low Back Pain: Subgroup Analyses of a Randomised Trial (the AIM Study).

Kristoffersen, Per M / Vetti, Nils / Grøvle, Lars / Brox, Jens I / Haugli Bråten, Lars C / Grotle, Margreth / Julsrud Haugen, Anne / Rolfsen, Mads P / Froholdt, Anne / Skouen, Jan S / Lutro, Olav / Marchand, Gunn H / Anke, Audny / Zwart, John-Anker / Storheim, Kjersti / Assmus, Jörg / Espeland, Ansgar

Spine

2022 Volume 48, Issue 3, Page(s) 147–154

Abstract: Study design: Exploratory subgroup analyses of a randomised trial [Antibiotics in Modic changes (AIM) study].: Objective: The aim was to assess the effect of amoxicillin versus placebo in reducing Modic change (MC) edema in patients with chronic low ... ...

Abstract	Study design: Exploratory subgroup analyses of a randomised trial [Antibiotics in Modic changes (AIM) study]. Objective: The aim was to assess the effect of amoxicillin versus placebo in reducing Modic change (MC) edema in patients with chronic low back pain. Summary of background data: The AIM study showed a small, clinically insignificant effect of amoxicillin on pain-related disability in patients with chronic low back pain and MC type 1 (edema type) on magnetic resonance imaging (MRI). Materials and methods: A total of 180 patients were randomised to receive 100 days of amoxicillin or placebo. MC edema was assessed on MRI at baseline and one-year follow-up. Per-protocol analyses were conducted in subgroups with MC edema on short tau inversion recovery (STIR) or T1/T2-weighted MRI at baseline. MC edema reductions (yes/no) in STIR and T1/T2 series were analyzed separately. The effect of amoxicillin in reducing MC edema was analyzed using logistic regression adjusted for prior disk surgery. To assess the effect of amoxicillin versus placebo within the group with the most abundant MC edema on STIR at baseline ("STIR3" group), we added age, STIR3 (yes/no), and STIR3×treatment group (interaction term) as independent variables and compared the marginal means (probabilities of edema reduction). Results: Compared to placebo, amoxicillin did not reduce MC edema on STIR (volume/intensity) in the total sample with edema on STIR at baseline (odds ratio 1.0, 95% CI: 0.5, 2.0; n=141) or within the STIR3 group (probability of edema reduction 0.69, 95% CI: 0.47, 0.92 with amoxicillin and 0.61, 95% CI: 0.43, 0.80 with placebo; n=41). Compared with placebo, amoxicillin did not reduce MC edema in T1/T2 series (volume of the type 1 part of MCs) (odds ratio: 1.0, 95% CI: 0.5, 2.3, n=104). Edema declined in >50% of patients in both treatment groups. Conclusions: From baseline to one-year follow-up, amoxicillin did not reduce MC edema compared with placebo. Level of evidence: 2.
MeSH term(s)	Humans ; Amoxicillin/therapeutic use ; Amoxicillin/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Low Back Pain/drug therapy ; Low Back Pain/pathology ; Lumbar Vertebrae/pathology ; Magnetic Resonance Imaging ; Edema/drug therapy
Chemical Substances	Amoxicillin (804826J2HU) ; Anti-Bacterial Agents
Language	English
Publishing date	2022-10-12
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000004513
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Article: Disc height and sagittal alignment in operated and non-operated levels in the lumbar spine at long-term follow-up: a case-control study.

Froholdt, Anne / Brox, Jens Ivar / Reikerås, Olav / Leivseth, Gunnar

The open orthopaedics journal

2013 Volume 7, Page(s) 258–263

Abstract: Purpose: To compare lumbar disc degeneration at 9-year follow-up in patients with chronic low back pain who had instrumented lumbar fusion or no fusion.: Material and methodology: The main outcomes were disc height and sagittal alignment measured by ... ...

Abstract	Purpose: To compare lumbar disc degeneration at 9-year follow-up in patients with chronic low back pain who had instrumented lumbar fusion or no fusion. Material and methodology: The main outcomes were disc height and sagittal alignment measured by Distortion Compensated Roentgen Analysis (DCRA). Secondary outcome included the Oswestry Disability Index and VAS back pain. Results: Forty-eight patients with baseline and 9-year radiographs from L2- S1 were included. Twenty-three had lumbar fusion and 25 had no fusion. Disc height was reduced at all levels independent of fusion. No difference in disc height and sagittal alignment was observed between patients fused and not fused. There were weak correlations, ranging from 0.04 to 0.36, between clinical and radiological parameters. Conclusion: Lumbar disc degeneration increased at all measured levels independent of fusion and correlated poorly with clinical outcome.
Language	English
Publishing date	2013-06-28
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2395994-0
ISSN	1874-3250
ISSN	1874-3250
DOI	10.2174/1874325001307010258
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Article ; Online: Low risk of injuries among children playing organized soccer: a prospective cohort study.

Froholdt, Anne / Olsen, Odd Egil / Bahr, Roald

The American journal of sports medicine

2009 Volume 37, Issue 6, Page(s) 1155–1160

Abstract: Background: The injury rate in soccer is high, and studies have shown that the injury rate among players aged 16 years or older approaches that of adult players. However, little is known about the injury risk among the youngest players, that is, players ...

Abstract	Background: The injury rate in soccer is high, and studies have shown that the injury rate among players aged 16 years or older approaches that of adult players. However, little is known about the injury risk among the youngest players, that is, players between 6 and 12 years. Purpose: To examine the risk of injuries in children 6 to 16 years old playing organized soccer. Study design: Descriptive epidemiological study. Methods: Injuries were recorded prospectively throughout 1 season among 121 soccer teams (1879 players, aged 6-16 years) from 2 communities in the southeastern part of Norway. Results: A total of 159 players sustained 200 injuries, corresponding to an overall injury incidence of 2.2 per 1000 playing hours (95% confidence interval, 1.8-2.6) among boys and 2.0 injuries per 1000 hours (95% confidence interval, 1.4-2.5) among girls. The overall injury incidence was significantly higher (relative risk, 1.7; 95% confidence interval, 1.3-2.2) among older players (13-16 years; 2.6 injuries per 1000 hours, 95% confidence interval, 2.2-3.0) than among younger players (6-12 years; 1.6 injuries per 1000 hours, 95% confidence interval, 1.2-1.9). The injuries recorded in the youngest group were few and mainly mild. Conclusion: The injury risk among young players (6-12 years) playing organized 5- or 7-a-side soccer is low, lower than that of adolescents and much lower than at the elite level. Soccer is a safe sport for children.
MeSH term(s)	Adolescent ; Athletic Injuries/classification ; Athletic Injuries/epidemiology ; Athletic Injuries/physiopathology ; Child ; Cohort Studies ; Epidemiologic Studies ; Female ; Humans ; Male ; Norway/epidemiology ; Prospective Studies ; Risk Assessment ; Soccer/injuries
Language	English
Publishing date	2009-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	197482-8
ISSN	1552-3365 ; 0363-5465
ISSN (online)	1552-3365
ISSN	0363-5465
DOI	10.1177/0363546508330132
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Article ; Online: Clinical effect modifiers of antibiotic treatment in patients with chronic low back pain and Modic changes - secondary analyses of a randomised, placebo-controlled trial (the AIM study).

Bråten, Lars Christian Haugli / Grøvle, Lars / Espeland, Ansgar / Pripp, Are Hugo / Grotle, Margreth / Helllum, Christian / Haugen, Anne Julsrud / Froholdt, Anne / Rolfsen, Mads Peder / Nygaard, Øystein Petter / Lutro, Olav / Kristoffersen, Per Martin / Anke, Audny / Schistad, Elina Iordanova / Skouen, Jan Sture / Brox, Jens Ivar / Zwart, John-Anker / Storheim, Kjersti

BMC musculoskeletal disorders

2020 Volume 21, Issue 1, Page(s) 458

Abstract: Background: Randomised trials on antibiotic treatment for patients with chronic low back pain and vertebral endplate changes visible on MRI (Modic changes) have shown mixed results. A possible explanation might be a real treatment effect in subgroups of ...

Abstract	Background: Randomised trials on antibiotic treatment for patients with chronic low back pain and vertebral endplate changes visible on MRI (Modic changes) have shown mixed results. A possible explanation might be a real treatment effect in subgroups of the study populations. The purpose of the present study was to explore potential clinical effect modifiers of 3-months oral amoxicillin treatment in patients with chronic low back pain and type I or II Modic changes at the level of a previous lumbar disc herniation. Methods: We performed analyses of effect modifiers on data from AIM, a double-blind parallel-group multicentre trial. One hundred eighty patients with chronic low back pain, previous disc herniation, Modic change type I (n = 118) or type II (n = 62) were randomised to 3-months oral treatment with 750 mg amoxicillin (n = 89) or placebo (n = 91) three times daily. The primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (possible values 0-24) at 1-year follow-up in the intention-to-treat population. The predefined minimal clinically important between-group mean difference was 4 RMDQ points (not reached in the primary analysis of AIM). Predefined baseline characteristics were analysed as potential effect modifiers, four primary (type I Modic changes, previous disc surgery, positive pain provocation test, high CRP) and five exploratory (disturbed sleep, constant low back pain, short duration of low back pain, younger age, and male) using ANCOVA with interaction terms. Results: None of the four primary potential effect modifiers had strong evidence of modifying the treatment effect. In patients younger than 40 years the difference in mean RMDQ score between the treatment groups was - 4.0 (95%CI, - 6.9 to - 1.2), compared to - 0.5 (95%CI, - 2.3 to 1.3) in patients 40 years or older, both in favour of amoxicillin treatment (exploratory analysis). Conclusions: We did not find evidence for convincing clinical effect modifiers of antibiotic treatment in patients with chronic low back pain and Modic changes. Our results for younger age in these explorative analyses should not affect clinical treatment decisions without confirmation in future studies. Trial registration: ClinicalTrials.gov NCT02323412 , First registered 23 December 2014.
MeSH term(s)	Administration, Oral ; Anti-Bacterial Agents/therapeutic use ; Humans ; Intention ; Low Back Pain/diagnostic imaging ; Low Back Pain/drug therapy ; Lumbar Vertebrae/diagnostic imaging ; Male ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2020-07-13
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ISSN	1471-2474
ISSN (online)	1471-2474
DOI	10.1186/s12891-020-03422-y
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Article ; Online: Cost-utility analysis of antibiotic treatment in patients with chronic low back pain and Modic changes: results from a randomised, placebo-controlled trial in Norway (the AIM study).

Grotle, Margreth / Bråten, Lars Christian / Brox, Jens Ivar / Espeland, Ansgar / Zolic-Karlsson, Zinajda / Munk Killingmo, Rikke / Tingulstad, Alexander / Grøvle, Lars / Froholdt, Anne / Kristoffersen, Per Martin / Wigemyr, Monica / van Tulder, Maurits W / Storheim, Kjersti / Zwart, John-Anker

BMJ open

2020 Volume 10, Issue 6, Page(s) e035461

Abstract: Objective: To evaluate the cost-utility of 100 days of antibiotics in patients with chronic low back pain (LBP) and type I or II Modic changes included in the Antibiotic treatment In patients with chronic low back pain and Modic changes (AIM) study.: ... ...

Abstract	Objective: To evaluate the cost-utility of 100 days of antibiotics in patients with chronic low back pain (LBP) and type I or II Modic changes included in the Antibiotic treatment In patients with chronic low back pain and Modic changes (AIM) study. Design: A cost-utility analysis from a societal and healthcare perspective alongside a double-blinded, parallel group, placebo, multicentre trial. Setting: Hospital outpatient clinics at six hospitals in Norway. The main results from the AIM study showed a small effect in back-related disability in favour of the antibiotics group, and slightly larger in those with type I Modic changes, but this effect was below the pre-defined threshold for clinically relevant effect. Participants: 180 patients with chronic LBP, previous disc herniation and Modic changes type I (n=118) or type II (n=62) were randomised to antibiotic treatment (n=89) or placebo-control (n=91). Interventions: Oral treatment with either 750 mg amoxicillin or placebo three times daily for 100 days. Main outcome measures: Quality-adjusted life years (QALYs) by EuroQoL-5D over 12 months and costs for healthcare and productivity loss measured in Euro (€1=NOK 10), in the intention-to-treat population. Cost-utility was expressed in incremental cost-effectiveness ratio (ICER). Results: Mean (SD) total cost was €21 046 (20 105) in the amoxicillin group and €19 076 (19 356) in the placebo group, mean difference €1970 (95% CI; -3835 to 7774). Cost per QALY gained was €24 625. In those with type I Modic changes, the amoxicillin group had higher healthcare consumption than the placebo group, resulting in €39 425 per QALY gained. Given these ICERs and a willingness-to-pay threshold of €27 500 (NOK 275 000), the probability of amoxicillin being cost-effective was 51%. Even when the willingness-to-pay threshold increased to €55 000, the probability of amoxicillin being cost-effective was never higher than 53%. Conclusions: Amoxicillin treatment showed no evidence of being cost-effective for people with chronic LBP and Modic changes during 1-year follow-up. Trial registration number: ClinicalTrials.gov NCT02323412.
MeSH term(s)	Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Bone Marrow Diseases/drug therapy ; Chronic Disease ; Cost-Benefit Analysis ; Double-Blind Method ; Edema/drug therapy ; Humans ; Intention to Treat Analysis ; Low Back Pain/drug therapy ; Low Back Pain/economics ; Middle Aged ; Norway ; Pain Measurement ; Quality-Adjusted Life Years
Chemical Substances	Anti-Bacterial Agents ; Amoxicillin (804826J2HU)
Keywords	covid19
Language	English
Publishing date	2020-06-15
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2019-035461
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Article ; Online: No difference in 9-year outcome in CLBP patients randomized to lumbar fusion versus cognitive intervention and exercises.

Froholdt, Anne / Reikeraas, Olav / Holm, Inger / Keller, Anne / Brox, Jens Ivar

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2012 Volume 21, Issue 12, Page(s) 2531–2538

Abstract: Purpose: To compare the 9-year outcome in patients with chronic low back pain treated by instrumented lumbar fusion versus cognitive intervention and exercises.: Methods: The main outcome measure was the Oswestry Disability Index (ODI). Secondary ... ...

Abstract	Purpose: To compare the 9-year outcome in patients with chronic low back pain treated by instrumented lumbar fusion versus cognitive intervention and exercises. Methods: The main outcome measure was the Oswestry Disability Index (ODI). Secondary outcome measures included pain, fear-avoidance beliefs, trunk muscle strength, medication, and return to work. Results: One-third of the patients randomized to cognitive intervention and exercises had crossed over and been operated and one-third of the patients allocated to lumbar fusion had been re-operated. The intention-to-treat analysis detected no differences between the two groups. The mean adjusted treatment effect for ODI was 1.9 (95 % CI -7.8 to 11.6). Analysed according to the treatment received, more operated patients used pain medication and were out of work. Conclusions: The outcome at 9 years was not different between instrumented lumbar fusion and cognitive intervention and exercises.
MeSH term(s)	Adult ; Chronic Pain/rehabilitation ; Chronic Pain/surgery ; Cognitive Behavioral Therapy ; Exercise Therapy ; Female ; Humans ; Low Back Pain/rehabilitation ; Low Back Pain/surgery ; Lumbar Vertebrae ; Male ; Middle Aged ; Spinal Fusion ; Treatment Outcome
Language	English
Publishing date	2012-06-06
Publishing country	Germany
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-012-2382-0
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Article ; Online: No difference in long-term trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain 7 to 11 years after lumbar fusion versus cognitive intervention and exercises.

Froholdt, Anne / Holm, Inger / Keller, Anne / Gunderson, Ragnhild B / Reikeraas, Olav / Brox, Jens I

The spine journal : official journal of the North American Spine Society

2011 Volume 11, Issue 8, Page(s) 718–725

Abstract: Background context: Reduced muscle strength and density observed at 1 year after lumbar fusion may deteriorate more in the long term.: Purpose: To compare the long-term effect of lumbar fusion and cognitive intervention and exercises on muscle ... ...

Abstract	Background context: Reduced muscle strength and density observed at 1 year after lumbar fusion may deteriorate more in the long term. Purpose: To compare the long-term effect of lumbar fusion and cognitive intervention and exercises on muscle strength, cross-sectional area, density, and self-rated function in patients with chronic low back pain (CLBP) and disc degeneration. Study design: Randomized controlled study with a follow-up examination at 8.5 years (range, 7-11 years). Patients and methods: Patients with CLBP and disc degeneration randomized to either instrumented posterolateral fusion of one or both of the two lower lumbar levels or a 3-week cognitive intervention and exercise program were included. Isokinetic muscle strength was measured by a Cybex 6000 (Cybex-Lumex, Inc., Ronkonkoma, NY, USA). All patients had previous experience with the test procedure. The back extension (E) flexion (F) muscles were tested, and the E/F ratios were calculated. Cross-sectional area and density of the back muscles were measured at the L3-L4 segment by computed tomography. Patients rated their function by the General Function Score. Outcome measures: Trunk muscle strength, cross-sectional area, density, and self-rated function. Results: Fifty-five patients (90%) were included at long-term follow-up. There were no significant differences in cross-sectional area, density, muscle strength, or self-rated function between the two groups. The cognitive intervention and exercise group increased trunk muscle extension significantly (p<.05), and both groups performed significantly better on trunk muscle flexion tests (p<.01) at long-term follow-up. On average, self-rated function improved by 56%, cross-sectional area was reduced by 8.5%, and muscle density was reduced by 27%. Conclusion: Although this study did not assess the morphology of muscles likely damaged by surgery, trunk muscle strength and cross-sectional area above the surgical levels are not different between those who had lumbar fusion or cognitive intervention and exercises at 7- to 11-year follow-up.
MeSH term(s)	Adult ; Chronic Disease ; Cognitive Therapy ; Exercise Therapy/methods ; Female ; Follow-Up Studies ; Humans ; Low Back Pain/psychology ; Low Back Pain/rehabilitation ; Low Back Pain/surgery ; Lumbar Vertebrae ; Male ; Muscle Strength ; Muscle, Skeletal/pathology ; Recovery of Function ; Spinal Fusion ; Time ; Tomography, X-Ray Computed ; Treatment Outcome
Language	English
Publishing date	2011-08
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2011.06.004
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Article ; Online: High prevalence of vertebral fractures and low trabecular bone score in patients with fragility fractures: A cross-sectional sub-study of NoFRACT.

Bone

2019 Volume 122, Page(s) 14–21

Abstract: Purpose: Norway has among the highest incidence rates of fractures in the world. Vertebral fracture assessment (VFA) and trabecular bone score (TBS) provide information about fracture risk, but their importance have not been studied in Norwegian ... ...

Abstract	Purpose: Norway has among the highest incidence rates of fractures in the world. Vertebral fracture assessment (VFA) and trabecular bone score (TBS) provide information about fracture risk, but their importance have not been studied in Norwegian patients with fragility fractures. The objectives of this study were to examine the clinical characteristics of a cohort of women and men with fragility fractures, their prevalence of vertebral fractures using VFA and prevalence of low TBS, and explore the differences between the sexes and patients with and without vertebral fractures. Methods: This cross-sectional sub-study of the Norwegian Capture the Fracture Initiative (NoFRACT) included 839 patients with fragility fractures. Of these, 804 patients had bone mineral density (BMD) of the total hip, femoral neck and/or spine assessed using dual energy x-ray absorptiometry, 679 underwent concomitant VFA, 771 had TBS calculated and 696 responded to a questionnaire. Results: Mean age was 65.8 (SD 8.8) years and 80.5% were women. VFA revealed vertebral fractures in 34.8% of the patients and 34.0% had low TBS (≤ 1.23), with no differences between the sexes. In all patients with valid measures of both VFA and TBS, 53.8% had either vertebral fractures, low TBS, or both. In the patients with osteopenia at the femoral neck, 53.6% had either vertebral fractures, low TBS, or both. Femoral neck BMD T-score ≤ -2.5 was found in 13.8% of all patients, whereas the corresponding figure was 27.4% using the skeletal site with lowest T-score. Women exhibited lower BMD at all sites and lower TBS than men (1.27 vs. 1.29), (all p < 0.05). Patients with prevalent vertebral fractures were older (69.4 vs. 64.0 years), exhibited lower BMD at all sites and lower TBS (1.25 vs.1.29) than those without vertebral fractures (all p < 0.05). Before assessment, 8.2% were taking anti-osteoporotic drugs (AOD), and after assessment, the prescription rate increased to 56.2%. Conclusions: More than half of the patients with fragility fractures had vertebral fractures, low TBS or both. The prescription of AOD increased seven fold from before assessment to after assessment, emphasizing the importance of risk assessment after a fragility fracture.
MeSH term(s)	Absorptiometry, Photon ; Aged ; Cancellous Bone/diagnostic imaging ; Cancellous Bone/pathology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Prevalence ; Risk Assessment ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/epidemiology
Language	English
Publishing date	2019-02-08
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632515-4
ISSN	1873-2763 ; 8756-3282
ISSN (online)	1873-2763
ISSN	8756-3282
DOI	10.1016/j.bone.2019.02.008
Database	MEDical Literature Analysis and Retrieval System OnLINE

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