![]() ![]() These pesky structural changes may limit your clinical effectiveness and patient satisfaction. This blog will dive deeply into one of the most common types of pain generators: vertebral fractures. ![]() Unfortunately, some pain generators within the spine are elusive to traditional orthopedic testing and history taking. All rights reserved.Effective and efficient chiropractors ask the right questions, allowing them to perform the most sensitive orthopedic testing to identify damaged tissue. Greater efforts are needed to improve the quality of the majority of guidelines.Ĭlinical guidelines Conservative care Diagnosis Intervention care Recommendation Systematic reviews Vertebral compression fracture.Ĭopyright © 2017 Elsevier Inc. The evidence available to guideline developers was limited in quantity and quality. The comparison of clinical guidelines for the management of VCF showed that diagnostic and therapeutic recommendations were generally inconsistent. The recommendation for bed rest, trunk orthoses, electrical stimulation, and supervised or unsupervised exercise was inconsistent across the included guidelines. Vertebroplasty or kyphoplasty was recommended in three of the four guidelines. The use of plain radiography or dual-energy X-ray absorptiometry for diagnosis was recommended in two of the four guidelines. The domains scoring 50% or less of the maximum possible score were rigor of development, clarity of presentation, and applicability. In general, the quality was not satisfactory (50% or less of the maximum possible score). Our study was prospectively registered on PROSPERO.įour guidelines from three countries, published in the period 2010-2013, were included. Guideline recommendations were grouped into diagnostic, conservative care, interventional care, and osteoporosis treatment and prevention of future fractures. We also classified the strength of each recommendation as either strong (ie, based on high-quality studies with consistent findings for recommending for or against the intervention), weak (ie, based on a lack of compelling evidence resulting in uncertainty for benefit or potential harm), or expert consensus (ie, based on expert opinion of the working group rather than on scientific evidence). The methodological quality of the guidelines was assessed by two authors independently using the Appraisal of Guidelines, Research and Evaluation (AGREE) II Instrument. We also searched clinical practice guideline databases, including the National Guideline Clearinghouse and the Canadian Medical Association InfoBase. Guidelines were selected by searching MEDLINE and PubMed, PEDro, CINAHL, and EMBASE electronic databases between 20. This is a systematic review of clinical guidelines for the management of VCF. The aim of this study was to appraise the recommendations and the methodological quality of international clinical guidelines for the management of VCFs. However, currently available clinical guidelines and recommendations, established by different medical societies, are sometimes contradictory. Clinical practice guidelines can be powerful tools for promoting evidence-based practice as they integrate research findings to support decision making. Vertebral compression fractures (VCFs) are the most common type of osteoporotic fracture comprising approximately 1.4 million cases worldwide. ![]()
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