Multidisciplinary management of acute osteoporotic vertebral fracture: results of a national Delphi consensus.

INTRODUCTION

Acute osteoporotic vertebral fractures (OVFs) are common and underdiagnosed complications of osteoporosis and are associated with pain, disability, functional impairment, and a high risk of secondary fractures. In Spain, the lack of unified protocols for clinical management contributes to the heterogeneity of care in both public and private health care systems. The objective of this study was to establish a national multidisciplinary consensus on the diagnostic, therapeutic, and follow-up criteria for acute OVFs adapted to the context of the Spanish health care system.

MATERIALS AND

METHODS

This Delphi process was an initiative promoted by the Spanish Spine Society (GEER) and coordinated by a multidisciplinary Scientific Steering Committee made up of eight members. A two-round Delphi methodology coordinated by a multidisciplinary Scientific Steering Committee was performed. Sixty-four experts from seven national scientific societies (orthopedic surgery, radiology, rheumatology, geriatrics, endocrinology, physical medicine and rehabilitation, and bone metabolism) participated. Forty-five statements were formulated and organized into eight thematic sections.

RESULTS

A consensus was reached on 44 of the 45 statements. It was agreed that diagnosis should begin with radiography and be complemented with magnetic resonance imaging (MRI) in symptomatic cases. Treatment should begin early with multimodal analgesia, early mobilization, calcium and vitamin D supplementation, and osteoprotective therapy, with a preference for anabolic agents in high-risk patients. The importance of secondary prevention programs, individualized rehabilitation, and comprehensive follow-up was emphasized. No consensus has been reached on the equivalence between vertebroplasty and kyphoplasty.

CONCLUSION

This consensus establishes a standardized and multidisciplinary clinical framework for managing acute OVFs in Spain, aiming to improve clinical outcomes, reduce care variability, and optimize health care resources.