The association of modic changes and disabling low back pain: a large-scale population-based study

INTRODUCTION: Modic changes (MC) are vertebral bone marrow changes adjacent to the endplates as noted on MRI. The association of specific MC type with low back pain (LBP) remains inconclusive, largely attributed to small sample sizes with limited phenotype assessment. Recently, the MC phenotype has been thoroughly defined. In relation to disabling LBP, various aspects of the topography and morphology of MC have not been properly assessed. As such, this study evaluated the relationship of disabling LBP with lumbar MC based on an extensive ...postprin

Ciculating CCL5/RANTES: a potential biomarker for human intervertebral disc degeneration

INTRODUCTION: Clinical studies have shown that moderate to severe lumbar disc degeneration (DD) on MRI increases the risk of developing low back pain and its severity. The pro‐inflammatory chemokine CCL5/RANTES is released by degenerative discs and has been associated with discogenic back pain. As such, this study addressed if circulating CCL5/RANTES may be increased in subjects with DD compared to physiological concentrations in individuals ...postprin

A secondary Fracture Prevention Programme to reduce fractures, hospital admissions, and mortality rates

Conference Theme: Happy Staff - Healthy People (開心員工 - 共建民康)published_or_final_versionThe Hospital Authority Convention, Hong Kong, 10-11 May 2010

Evaluation of the Osteoporosis Secondary Fracture Prevention Program at Queen Mary Hospital: successful recruitment is associated with lower re-fracture rate and mortality rate at one year

Conference Theme: Happy Staff - Healthy People (開心員工 - 共建民康)published_or_final_versionThe Hospital Authority Convention, Hong Kong, 10-11 May 2010

Rate of perimenopausal bone loss and its predictive factors among Asian females

The International Osteoporosis Foundation (IOF) World Congress on Osteoporosis & 10th European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (IOF WCO-ECCEO10), Florence, Italy, 5-8 May 2010

Prospective correlation study between ultrasound and radiographs for monitoring distractions in magnetically-controlled growing rods

Session 2 - Free Papers: no.

Factors associated with osteoporosis treatment adherence in Hong Kong

Poster presentations: Poster 6Introduction: Effective prevention of osteoporotic fracture requires long term adherence to osteoporosis medication. Longitudinal studies revealed that more than 60% of patients terminated their treatment at one year and the problem increases with time. The problem of non-adherence to osteoporosis medication in Hong Kong is unclear. Objective: To assess patient adherence to osteoporosis medication in Hong Kong and to identify the associating factors for nonadherence. Method: 244 patients attended the osteoporosis clinic in Queen Mary Hospital for the first time between January 2007 and December 2008 were invited to participate in a retrospective observational study for their adherence to treatment. Baseline clinical and demographic information, bone mineral density, lifestyle risk factors were assessed by medical charts review. Details in treatment adherence, acceptance, incident fractures, hospital admission and mobility level were collected by telephone interviews. Information were verified from the Hospital Authority Electronic Patient Record System. Medication compliance was measured by proportion of days covered (PDC). A patient is considered as a complier if he/she had missed < 20% of the proportion of days covered (PDC). Results: A total of 193 patients participated in this study with 79.1 % response rate. The mean rate of medication adherence was 75.3% (PDC) after a mean follow up of 2.3 years. The rate of medication adherence decreased progressively with follow up duration (PDC: 74.5% at first year, 75.6% at second year, 63.7% at third year). The risk factors for non-adherence to treatment were self-perceived having too many medications (OR: 19.77, 95% CI: 2.41-161.99, p<0.001); self-perceived adverse effect from medication (OR: 16.98, 95% CI: 2.04-141.35, p=0.001); self-perceived cannot afford the medication (OR: 14.29, 95% CI: 1.68-121.5, p=0.004); self-perceived not requiring the medication (OR: 9.53, 95% CI: 2.99-30.42, p <0.001); bedbound (OR: 9.19, 95% CI: 1.00-84.08, p=0.035); smoking (OR: 3.97, 95% CI: 1.23-12.76, p=0.025); unsatisfied with medication (OR: 3.17, 95% CI: 1.05-9.59, p=0.04) and medication adverse effect (OR: 1.15, 95% CI: 1.04-1.27, p<0.001). Conclusion: Although the rate of non-adherence in our study was lower than reported by overseas studies, the problem exacerbated with longer treatment duration. Several self-perceived factors were found associated with patient non-adherence. This study identified the common misconceptions and concerns about osteoporosis medications among patients that required long term treatment. To lower the non-adherence rate, doctors should improve their communications with patients to resolve their concerns with long term medical therapy.The 11th Regional Osteoporosis Conference (ROC), Hong Kong, 15-16 May 2010

Distraction failure in magnetically-controlled growing rods: prevalence and risk factors

Poster presentation: Abstract No.: 40275INTRODUCTION: Recently, the use of 'magnetically' controlled growing rods (MCGR) has advanced the surgical treatment of early onset scoliosis (EOS), providing non-invasive distractions. Occassionally the rod may fail to distract due to slippage of the internal mechanism. This study assessed the occurrence and potential determinants associated with slippage of the MCGR during distraction. METHODS: We prospectively assessed 4 EOS patients with implantation of dual MCGR. Each underwent monthly outpatient distractions. Rod slippage was noted if a 'clunking' noise occurred during distraction. Rradiographic parameters and demographics were analysed. RESULTS: The mean time period from operation to the first slippage was 11 months. Overall, in 168 distraction episodes, slippage was noted in 25%. Offset rod (35%) had more slippage compared to the standard rod (17%). Early slippage (within one year of surgery) occurred in 50% of the patients. Based on the sample size, demographics, number of vertebral levels involved, distance between magnets, and curve alignment/flexibility parameters were not distinctively involved in rod slippage. Despite this slippage, there was overall gain in the implant and the spine. Throughout follow-up, all patients had no pain, had good functional outcome, and were satisfied with the procedure. CONCLUSION: In MCGR patients, rod slippage can occur within the first year since implantation and may continue thereafter. This is the first study to identify this observation. Larger studies are needed to further validate our findings and determine if such an event is a potential complication or a naturally occurring, physiological fail-safe mechanism that benefits the patient

Magnetically-controlled growing rods: does the Law of Diminishing Returns apply?

Session 6: Early Onset, Congenital and Neuromuscular: Paper 7