539 The role of rehabilitation and anabolic treatment in severe osteoporosis associated with significant vitamin D deficiency – case report

Abstract

Abstract: It is well known that vitamin D deficiency increases the risk of osteoporosis and
that vertebral compressions fractures are a manifestation of osteoporosis. This paper
presents the case of a patient with severe osteoporosis associated with vitamin D
deficiency who developed over the course of two years multiple vertebral compression
fractures. Method: We present the case of a 76‐year‐old caucasian female diagnosed with
osteoporosis and significant vitamin D deficiency who was investigated for mechanical
pain and functional deficit at the level of the spine and walking disorders. The patient was
hospitalized in our Rehabilitation department twice. At the first hospitalization two years
ago, the deficiency of vitamin D was found and the treatment was initiated. During the
second hospitalization, biochemical and radiological investigations were per‐formed to establish
the diagnosis. Numerous vertebral compression fractures were dis‐covered which were not re‐
vealed in the imaging investigations performed two years earli‐er. She underwent symptomatic and
appropriate medical rehabilitation treatment. Results and discussion: The evolution was favorable
after the hospitalization period, with a decrease in pain and functional deficit, as well as walking
improvement. After endocrinological consultation it was decided to initiate therapy with Teripar‐
atide which can decrease the risk of future fractures and reduce the back pain. Conclusions: Ade‐
quate and prompt treatment of vitamin D deficiency and osteoporosis is very important to avoid
vertebral compression fractures or other complications of this disease. Physical and rehabilitation
medicine also plays an important role in management of these patients.

Keywords: osteoporosis, vitamin D deficiency, vertebral compression, teriparatide