A Progressive Spontaneous Cervical Compression Fracture Over Years Following Long-Term Corticosteroid Use.

Spontaneous vertebral compression fractures in the cervical region can have a significant impact on a patient's condition even after surgical management. Due to the rarity of spontaneous cervical vertebral compression fractures and the lack of a comprehensive description of this condition, the establishment of a clear understanding of its natural course remains incomplete. In this case study, a 73-year-old woman on long-term corticosteroid therapy underwent combined anterior and posterior fixation for a spontaneous vertebral compression fracture at the C3-C4 level. The vertebral compression fracture gradually worsened over a span of four years. Following the surgery, the patient experienced a temporary improvement in her neurological symptoms. However, seven months after the second operation, an instrumentation failure resulted in the patient becoming bedridden. This highlights the importance of considering the potential long-term implications and monitoring patients closely even after surgical intervention.

Osteoking downregulates Mgp in an osteoporotic fracture rat model.

OBJECTIVE: To investigate the effectiveness of osteoking, a Traditional Chinese Medicine originating from Yi nationality, against osteoporosis (OP) and osteoporotic fracture (OPF), and to elucidate its mechanism of action. METHODS: An osteoporotic fracture rat model was established; animals were divided into three treatment groups: parathyroid hormone, osteoking and 0.9%NaCl. After 4, 8 and 12 weeks of treatment, serum and bone tissues were collected. Enzyme-linked immuno sorbent assay, x-ray, histopathological evaluation and proteomics were used. Proteomics and GO annotation were performed based on identified peptides. The relative network was obtained from the STRING database and verified by polymerase chain reaction and Western blotting. RESULTS: After osteoking treatment, the bone mineral density (BMD) increased with time in the osteoking group. At week 12, the BMD and bone mineral salt content of the osteoking group were 4.5% and 20.6% higher than those of the negative control group, respectively. Furthermore, the body weight followed the order of positive control group > osteoking group > negative control group, with significant differences among the groups (P < 0.05). Micro-CT analysis of femur sections revealed that the bone surface/volume ratio was significantly higher in the osteoking group than that in the negative control group. X-ray images demonstrated that the osteoking group showed clear callus. Moreover, high-voltage micro-CT demonstrated a massive cortical bone accumulation in the osteoking group. The gray values of callus in the osteoking group were higher than those in the negative group. From week 4 to 12, the serum bone alkaline phosphatase level increased by 49.6% in the osteoking group and the serum propeptide of type Ⅰprocollagen level decreased by 80.6%. Alizarin red staining demonstrated that the calcium deposition in the osteoking group was higher than that in the negative control group. Notably, the expression of Mgp, a key osteogenesis inhibitor, was lower in the osteoking group compared with the negative control group. Moreover, Sparc, bone morphogenetic protein-2 and Bglap expression was higher in the osteoking group through activation of the transforming growth factor-receptor activator of nuclear factor κB Ligand pathway. CONCLUSION: Osteoking treatment increased bone quality and promoted calcium deposition. The results suggest that osteoking inhibits Mgp through the TGF-ß/RANKL pathway to improve OP/OPF.

Effect of Trifolium pratense isoflavones on osteoporosis rats induced by estrogen deficiency / 中国药学杂志

OBJECTIVE: To examine the effects of Trifolium pratense isoflavones (TPIF), the main active component of Trifolium pratense L., on ovariectomy-induced osteoporosis in rats. METHODS: A total of 60 six-month-old female rats were randomly assigned to a sham-operated group and five ovariectomized(OVX) groups, ie, OVX with vehicle(10 mL · kg-1 · d-1, ig), OVX with graded doses of TPIF(30, 60, and 90 mg · kg-1 · d-1, ig), and OVX with nilestriol(2.5 mg · kg-1 · week-1, ig). The animals were sacrificed after 12-week treatment. RESULTS: Compared to the OVX group, TPIF significantly inhibited the increase of body weight. In addition, TPIF administration significantly decreased serum levels of alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP), and increased serum level of estrogen. CONCLUSION: TPIF may be a potential alternative medicine for the prevention and treatment of postmenopausal osteoporosis. Its mechanism may be related to increasing estrogen level, inhibiting bone resorption, and promoting bone formation.

Factores de riesgo para fracturas en mujeres mayores de 60 años / Risks factors for fractures in women older than 60 years old

Introducción: Doscientos millones de mujeres, de más de sesenta años padecen secuelas de fracturas asociadas a factores de riesgo como tabaquismo, sedentarismo y multiparidad, para el año 2050 una de cada dos fracturas se presentará con asociación de los factores mencionados. Objetivo: Determinar la asociación de tabaquismo, sedentarismo y multiparidad con la presencia o no de fractura. Metodología: Estudio analítico, transversal, retrospectivo. En 200 pacientes mayores de 60 años con y sin fractura actual o antigua, corroborada por radiografía y/o registro en el expediente clínico, sin datos de patología agregada de osteogénesis imperfecta, hipoparatiroidismo, insuficiencia renal y Síndrome de Cushing. Se aplicó cuestionario previamente validado. Resultados: Se analizaron doscientas pacientes (n), cien con fractura y cien sin fractura. Respecto a los factores, se buscan riesgos relacionados con presencia de fractura o no. Para tabaquismo y sedentarismo OR=1.8, multiparidad OR=1.3 veces más riesgo de presentar fractura y a través de la Prueba exacta de Fisher se demostró asociación media para tabaquismo y sedentarismo (r=0.6) y baja para multiparidad (r=0.3). Conclusiones: El presente estudio cumple con el objetivo de identificar la asociación de tabaquismo, sedentarismo y multiparidad como factores de riesgo para fractura y propone acciones de prevención en toda la población femenina sin importar su edad.

Introduction: Two hundred millions of women older than sixty years old suffer sequels of fractures associated to risk factors, such as smoking, sedentary life, and multiple deliveries. By 2050, one in two fractures will show up with association to the mentioned factors. Objective: To determine the association of smoking, sedentary life, and multiple deliveries, and whether the occurrence or not of fracture. Methodology: Analytical, transversal, and retrospective study. A questionnaire previously validated was applied to 200 patients older than 60 years old and with or without current or old fracture, corroborated by X-ray and/or record in medical chart; without data of aggregated pathology of imperfect osteogenesis, hypoparathyroidism, renal insufficiency, and Cushing Syndrome. Results: A total 200 patients (n) were analyzed; 100 with fracture and 100 without it. Regarding the risk factors; they are intended to be related (OR) with presence of fracture or not. For smoking and sedentarism OR=1.8; multiple deliveries OR=1.3 times more at risk of suffering fracture, and through the Fisher's Exact Test, it was demonstrated medium association for smoking and sedentarism (r=0.6) and low for multiple deliveries (r=0.3). Conclusions: The current study accomplishes the objective of identifying association of smoking, sedentarism, and multiple deliveries as risk factors for fracture; and proposes prevention measurements in the whole female population regardless their age.