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Behandling ved krum rygg

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Det finnes ingen standardbehandling for aldersrelatert hyperkyfose. Funn av beinskjørhet og ryggvirvelbrudd kan være indikasjon for behandling med midler mot beinskjørhet (bisfosfonater) eller annen beinskjørhetsbehandling, se beinskjørhet. Vi vet ikke om behandling av lav beinmineraltetthet kan bedre hyperkyfosen.

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Livsstilsfaktorer:

  • Fysisk aktivitet bidrar til å bremse utviklingen av beinskjørhet.
  • Slutt og røyk - røyking er en risikofaktor for beinskjørhet.
  • Det bør også utvises forsiktighet med alkohol - beruselse øker risikoen for å falle, noe som er ugunstig ved beinskjørhet.

Det er usikkerhet om nytten av korsett og ryggøvelser.

Ved smertefulle ryggvirvelbrudd er det mulig å gjøre mindre inngrep (vertebroplastikk og kyfoplastikk) som kan lindre uutholdelige smerter og muligens bedre krumningen. Behandlingen innebærer at det sprøytes inn beinsement i en sammenfalt virvel. Hos pasienter der ribbena støter mot hoftekammen og gir smerter, er det rapportert om gunstig effekt av å fjerne de ytre 2/3 av nederste ribben. Mer omfattende kirurgiske inngrep er forbundet med høy forekomst av komplikasjoner (33 prosent).

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Dette dokumentet er basert på det profesjonelle dokumentet Hyperkyfose hos eldre . Referanselisten for dette dokumentet vises nedenfor

  1. Kado DM, Prenovost K, Crandall C. Narrative review: hyperkyphosis in older persons. Ann Intern Med 2007; 147: 330-8. PubMed
  2. Kado DM. Overview of hyperkyphosis in older persons. UpToDate, last updated Mar 19, 2019. UpToDate
  3. Kado DM, Huang MH, Karlamangla AS, Barrett-Connor E, Greendale GA. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. J Am Geriatr Soc 2004; 52: 1662-7. PubMed
  4. Takahashi T, Ishida K, Hirose D, Nagano Y, Okumiya K, Nishinaga M, et al. Trunk deformity is associated with a reduction in outdoor activities of daily living and life satisfaction in community-dwelling older people. Osteoporos Int 2005; 16: 273-9. PubMed
  5. Schneider DL, von Mühlen D, Barrett-Connor E, Sartoris DJ. Kyphosis does not equal vertebral fractures: the Rancho Bernardo study. J Rheumatol 2004; 31: 747-52. PubMed
  6. Bartynski WS, Heller MT, Grahovac SZ, Rothfus WE, Kurs-Lasky M. Severe thoracic kyphosis in the older patient in the absence of vertebral fracture: association of extreme curve with age. AJNR Am J Neuroradiol 2005; 26: 2077-85. PubMed
  7. Boyle JJ, Milne N, Singer KP. Influence of age on cervicothoracic spinal curvature: an ex vivo radiographic survey. Clin Biomech (Bristol, Avon) 2002; 17: 361-7.
  8. Hinman MR. Comparison of thoracic kyphosis and postural stiffness in younger and older women. Spine J 2004; 4: 413-7. PubMed
  9. Di Bari M, Chiarlone M, Matteuzzi D, Zacchei S, Pozzi C, Bellia V, et al. Thoracic kyphosis and ventilatory dysfunction in unselected older persons: an epidemiological study in Dicomano, Italy. J Am Geriatr Soc 2004; 52: 909-15. PubMed
  10. Lombardi I Jr, Oliveira LM, Monteiro CR, Confessor YQ, Barros TL, Natour J. Evaluation of physical capacity and quality of life in osteoporotic women. Osteoporos Int 2004; 15: 80-5. PubMed
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  12. Kado DM, Huang MH, Barrett-Connor E, Greendale GA. Hyperkyphotic posture and poor physical functional ability in older community-dwelling men and women: the Rancho Bernardo study. J Gerontol A Biol Sci Med Sci 2005; 60: 633-7. PubMed
  13. Shipp KM, Guess HA, Ensrud KE, Nevitt MC, Kado DM, Cummings SR. Thoracic kyphosis and rate of incident vertebral fracture Abstract. J Bone Miner Res 2002; 17: 174. PubMed
  14. McGrother CW, Donaldson MM, Clayton D, Abrams KR, Clarke M. Evaluation of a hip fracture risk score for assessing elderly women: the Melton Osteoporotic Fracture (MOF) study. Osteoporos Int 2002; 13: 89-96. PubMed
  15. Miyakoshi N, Itoi E, Kobayashi M, Kodama H. Impact of postural deformities and spinal mobility on quality of life in postmenopausal osteoporosis. Osteoporos Int 2003; 14: 1007-12. PubMed
  16. Martin AR, Sornay-Rendu E, Chandler JM, Duboeuf F, Girman CJ, Delmas PD. The impact of osteoporosis on quality-of-life: the OFELY cohort. Bone 2002; 31: 32-6. PubMed
  17. Kado DM, Greendale GA, Lui L, Ensrud KE, Fink HA, Hillier T, et al. Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women Abstract. J Bone Miner Res 2003; 18: 249. PubMed
  18. Greendale GA, DeAmicis TA, Bucur A, et al. A prospective study of the effect of fracture on measured physical performance: results from the MacArthur Study--MAC. J Am Geriatr Soc 2000; 48: 546. PubMed
  19. Green AD, Colon-Emeric CS, Bastian L, et al. Does this woman have osteoporosis?. JAMA 2004; 292: 2890. Journal of the American Medical Association
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  21. Bartynski WS, Heller MT, Grahovac SZ, et al. Severe thoracic kyphosis in the older patient in the absence of vertebral fracture: association of extreme curve with age. AJNR Am J Neuroradiol 2005; 26: 2077. PubMed
  22. Kado DM, Christianson L, Palermo L, Smith-Bindman R, Cummings SR, Greendale GA. Comparing a supine radiologic versus standing clinical measurement of kyphosis in older women: the Fracture Intervention Trial. Spine 2006; 31: 463-7. PubMed
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  25. Bansal S, Katzman WB, Giangregorio LM. Exercise for improving age-related hyperkyphotic posture: a systematic review. Arch Phys Med Rehabil 2014; 95:129. PubMed
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  28. Hulme PA, Krebs J, Ferguson SJ, Berlemann U. Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 2006; 31: 1983-2001. PubMed
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  30. Heary RF. Evaluation and treatment of adult spinal deformity. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J Neurosurg Spine 2004; 1: 9-18. PubMed
  31. Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA 2001; 285: 320. Journal of the American Medical Association
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