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Vertebral Compression Fractures and Osteoporosis

Teaser: 

Zain Nassrullah, 1 Germain Sophie Ngana MD, PhD,2 Markian Pahuta MD, PhD, FRCSC,3Mohammad Zarrabian MD, FRCSC,4 Daipayan Guha MD, PhD, FRCSC,5

1Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
2 Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.

3 Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.

4 Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.

5 Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.

CLINICAL TOOLS

Abstract: Osteoporosis and vertebral compression fractures are commonly encountered pathologies that can have a significant impact on mobility, quality of life, and overall morbidity. Here we review the diagnosis, epidemiology, and risk factors of osteoporosis, as well as the most recent recommendations for primary and secondary prevention. Additionally, the current treatment approaches of vertebral compression fractures are discussed, including the roles of non-operative and operative management, indications for surgical intervention, and the evidence available to support treatment decisions.
Key Words: osteoporosis, VCF, vertebroplasty, kyphoplasty.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

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Pre-test CME Quiz Post-test CME Quiz
Osteoporosis has a very large disease burden in Canada, and vertebral compression fractures are one of its most common complications.
The Fracture Risk Assessment Tool (FRAX) should be used to calculate a 10-year risk of fractures in order to guide the management of osteoporosis.
A vertebral compression fracture should be suspected in patients with a history of osteoporosis presenting with acute low back pain.
Operative treatment options of vertebral compression fractures include vertebroplasty and kyphoplasty, both of which have been shown to be safe and efficacious in clinical trials.
Physical activity as tolerated should be encouraged as part of a conservative approach to managing a vertebral compression fracture.
Plain radiographs can be used to assess for the presence of vertebral compression fractures, while MRI sequences can be used in determining the acuity of vertebral compression fractures.
Vertebral augmentation is indicated in vertebral compression fractures if the pain is intractable and limits ambulation despite appropriate analgesic therapy.
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Related Terms: Back Health, osteoporosis, VCF, vertebroplasty, kyphoplasty

Beyond the Breaking Point: Ontario’s Healthcare Emergency

Teaser: 

Dr. Alykhan Abdulla, BSC, MD, LMCC, CCFP, DipSportMed CASEM, FCFP, CTH (ISTM), CCPE, Masters Cert Phys Leader, ICD.D

is a comprehensive family doctor working in Manotick, Ontario, Board Director of the College of Family Physicians of Canada, Chair of the General Assembly at Ontario Medical Association and Director for Longitudinal Leadership Curriculum at the University of Ottawa Undergraduate Medical Education. Editor in Chief/Author Journal of Current Clinical Care SPORTS MEDICINE, Past Chair Section of General and Family Practice Ontario Medical Association, Bruyere Foundation

CLINICAL TOOLS

Abstract: Ontario’s healthcare system faces an unprecedented crisis characterized by chronic underinvestment, operational deficits, and systemic collapse. This analysis examines the current state of healthcare delivery in Ontario, where over 90% of hospitals operate with structural deficits, emergency departments experience wait times exceeding 59 hours, and surgical backlogs have reached 250,000 patients. The Financial Accountability Office projects a $21.3-billion funding shortfall by 2027-28, while critical staffing shortages—including 26,000 registered nurses below national averages—compound operational challenges. This crisis represents not temporary strain but fundamental system failure requiring immediate, sustained intervention through strategic investment in infrastructure, personnel, and operational funding mechanisms.
Key Words: Healthcare crisis, Ontario hospitals, nursing shortage, healthcare funding.
Financial Emergency: Over 90% of Ontario hospitals operate with structural deficits, with many relying on credit lines for basic operations and payroll
Critical Access Barriers: Emergency department wait times reach 59.4 hours in some regions, while 1,850 patients receive daily treatment on stretchers due to bed shortages
Workforce Crisis: Ontario faces a shortage of 26,000 registered nurses compared to national averages, with recruitment failing to match attrition rates
Infrastructure Deficit: Current hospital bed expansion plans fall 13,800 beds short of projected needs by 2032, failing to address population growth and aging demographics
Triage Geography: Healthcare access increasingly depends on geographic location rather than clinical need, indicating system-wide capacity failure
Hallway Medicine Normalization: The acceptance of substandard care delivery locations reflects dangerous adaptation to crisis conditions
Burnout-Attrition Cycle: Healthcare worker departures consistently outpace recruitment efforts, creating self-perpetuating staffing shortages
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Law and Ethics, Healthcare crisis, Ontario hospitals, nursing shortage, healthcare funding
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