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The vertebral compression fracture (VCF) clinical care pathway was developed by a multispecialty expert panel using the RAND™/UCLA Appropriateness Method (RAM). Below you’ll find a summary of patient-specific guidelines based on the panel’s recommendations.1
History of present illness:
Past medical history, including relative risk factors:
Physical Exam:
The probability of a VCF was categorized based on the number of signs and symptoms present:
Number of Signs |
Probability of VCF |
---|---|
1-3 |
Low probability |
4-6 |
Intermediate probability |
7 or more |
High probability |
After weighing the appropriateness of all advanced imaging modalities (MRI, CT, nuclear bone scan) for patients suspected of having VCF, the panel considered advanced imaging:
Clinical Finding |
Categories Considered |
---|---|
1. Duration of pain |
|
2. Advanced imaging findings (MRI, CT, nuclear bone scan) |
|
3. Degree of vertebral height reduction |
|
4. Kyphotic deformity |
|
5. Progression of vertebral height loss |
|
6. Evolution of symptoms |
|
7. Impact of VCF on daily functioning |
|
Panel recommendations on the appropriateness of treatment for VCF. Blue outlined boxes indicate a present condition.
Absolute contraindication:
Strong contraindication:
Usually contraindication:
Relative contraindication:
Generally not a contraindication:
Panel consensus was reached on the following statements related to follow-up of patients:
Explore additional clinical data for vertebroplasty and balloon kyphoplasty procedures.
EXPLORE CLINICAL DATAReprinted from The Spine Journal 2018, Hirsch JA, Beall DP, Chambers MR et al. Management of vertebral fragility fractures: a clinical care pathway developed by a multispecialty panel using the RAND/UCLA Appropriateness Method. Nov;18(11):2152-2161, Copyright 2018, with permission from Elsevier.