OJO  Vol.3 No.6 , October 2013
Successful Treatment of Spine Fracture for Diffuse Idiopathic Skeletal Hyperostosis with Teriparatide—A Report of Two Cases
Abstract: We experienced 2 cases of spinal fracture in patients aged 80 years or older with diffuse idiopathic skeletal hyperostosis (DISH). Since they decided not to undergo surgical treatment, we provided conservative treatment with teriparatide. There has been no previous study on teriparatide for spine fracture in DISH. This is the first report of the successful use of teriparatide to treat spine fracture in DISH without surgical intervention. Our patients were treated with teriparatide for 8-9 months after diagnosis of the fracture. Union was obtained in two cases and no adverse events were observed during treatment. Our report showed that teriparatide could be an alternative to conventional intervention in spinal fracture of DISH.
Cite this paper: Y. Iida, H. Takahashi, Y. Yokoyama, Y. Inoue, D. Suzuki, K. Hasegawa, S. Tsuge, W. Shishikura, K. Fukutake, R. Takamatsu, K. Nakamura, M. Sekiguchi and A. Wada, "Successful Treatment of Spine Fracture for Diffuse Idiopathic Skeletal Hyperostosis with Teriparatide—A Report of Two Cases," Open Journal of Orthopedics, Vol. 3 No. 6, 2013, pp. 278-282. doi: 10.4236/ojo.2013.36051.

[1]   L. A. Westerveld, J. J. Verlaan and F. C. Oner, “Spinal Fractures in Patients with Ankylosing Spinal Disorders: A Systematic Review of the Literature on Treatment, Neurological Status and Complications,” European Spine Journal, Vol. 18, 2009, pp. 145-156.

[2]   T. Caron, R. Bransford, Q. Nguyen, J. Agel, J. Chapman and C. Bellabarba, “Spine Farctures in Patients with Ankylosisng Spinal Disorders,” Spine, Vol. 35, 2010, pp. E458-E464.

[3]   D. Resnick and G. Niwayama, “Radiographic and Pathologic Features of Spinal Involvement in Diffuse Idiopathic Skeletal Hyperostosis,” Radiology, Vol. 119, 1976, pp. 559-568.

[4]   C. W. Denko and C. J. Malemud, “Body Mass Index and Blood Glucose: Correlations with Serum Insulin, Growth Hormone, and Insulin-Like Growth Factor-1 Levels in Patients with Diffuse Idiopathic Skeletal Hyperostosis (DISH),” Rheumatology International, Vol. 26, 2006, pp. 292-297.

[5]   C. Kiss, M. Szilagyi, A. Paksy and G. Poor, “Risk Factors for Diffuse Idiopathic Skeletal Hyperostosis: A Case-Control Study,” Rheumatology, Vol. 41, 2002, pp. 27-30.

[6]   E. Canalis, A. Giustina and J. P. Bilezikian, “Mechanisms of Anabolic Therapies for Osteoporosis,” The New England Journal of Medicine, Vol. 357, 2007, pp. 905-916.

[7]   M. Gass and B. Dawson-Hughes, “Preventing Osteoporosis-Related Fractures: An Overview,” American Journal of Medicine, Vol. 119, 2006, pp. 3S-11S.

[8]   R. P. Heaney, “Advances in Therapy for Osteoporosis,” Clinical Medicine & Research, Vol. 1, 2003, pp. 93-99.

[9]   Y. Jiang, J. J. Zhao, B. H. Mitlak, O. Wang, H. K. Genant and E. F. Eriksen, “Recombinant Human Parathyroid Hormone(1-34)(Teriparatide) Improves Both Cortical and Cancellous Bone Structure,” Journal of Bone and Mineral Research, Vol. 18, 2003, pp. 1932-1941.

[10]   R. Lindsay, H. Zhou, F. Cosman, J. Nieves, D. W. Dempster and A. B. Hodsman, “Effects of a One-Month Treatment with pth(1-34) on Bone Formation on Cancellous, Endocortical, and Periosteal Surfaces of the Human Ilium,” Journal of Bone and Mineral Research, Vol. 22, 2007, pp. 495-502.

[11]   R. M. Neer, C. D. Arnaud, J. R. Zanchetta, R. Prince, G. A. Gaich, J. Y. Reginster, A. B. Hodsman, E. F. Eriksen, S. Ish-Shalom, H. K. Genant, O. Wang and B. H. Miltlak, “Effect of Parathyroid Hormone(1-34) on Fractures and Bone Mineral Density in Postmenopausal Women with Osteoporosis,” The New England Journal of Medicine, Vol. 10, 2001, pp. 1434-1441.

[12]   F. M. Ulivieri, “Back Pain Treatment in Post-Menopausal Osteoporosis with Nertebral Fractures,” Aging Clinical and Experimental Research, Vol. 19, 2007, pp. 21-23.

[13]   C. H. Su, P. H. Tu, T. C. Yang and Y. Y. Tseng, “Comparison of the Therapeutic Effect of Teriparatide with That of Combined Vertebroplasty with Antiresorptive Agents for the Treatment of New-Onset Adjacent Vertebral Compression Fracture after Percutaneous Vertebroplasty,” Journal of Spinal Disorders & Techniques, Vol. 26, 2013, pp. 200-206.

[14]   P. T. Rubery and S. V. Bukata, “Teriparatide May Acceerate Healing in Delayed Unions of Type Ⅲ Odontoid Fractures. A Report of 3 Cases,” Journal of Spinal Disorders & Techniques, Vol. 23, 2010, pp. 151-155.

[15]   Y. K. Lee, Y. C. Ha and K. H. Koo, “Teriparatide, a Nonsurgical Solution for Femoral Nonunion? A Report of Three Cases,” Osteoporosis International, Vol. 23, 2012, pp. 2897-2900.

[16]   S. Chintamaneni, K. Finzel and B. L. Gruber, “Successful Treatment of Sternal Fracture Nonunion with Teriparatide,” Osteoporosis International, Vol. 21, 2010, pp. 1059-1063.

[17]   A. P. Johansson, “Teriparatide Improves Early Callus Formation in Distal Radial Fractures. Analysis of a Sub Group of Patients within a Randomized Trial,” Acta Orthopaedica, Vol. 81, 2010, pp. 234-236.