Initial Date: December 1, 2016
Expiration Date: December 31, 2018
Credits Available: 1.0 hour
Fee: Member-$0; Nonmember-$10

For information about NOF’s Clinical Updates and its Editorial Board.

Support for this activity, in the form of an educational grant, was received from Medtronic.

Activity Description
Vertebral compression fractures pose numerous distinct threats to health, longevity, and quality of life. When concentrated in the thoracic spine, VCFs contribute to restrictive lung disease and cardiac compromise. Fractures in the lumbar spine lead to constipation, abdominal distention, and weight loss. Spinal deformity caused by multiple fractures increases risk for falls and impedes ambulation by impairing balance and gait. And, when chronic back pain restricts a patient’s activities, the complications of immobility ensue – pneumonia, deep vein thrombosis, deconditioning, and bone loss. One fracture begets another, too often culminating in disability, deformity, and premature death.

In this article, the first of two on the subject, we explore the critical topic of osteoporosis-related vertebral fracture. We discuss the factors that lead to pathologic changes in the spine, the types of fractures that result, their consequences to physical and psychological health, and both how to diagnose these fractures and how to distinguish them from the myriad other causes of back pain. In the second article, we will discuss the spectrum of therapeutic options for VCF and the growing evidence base that clinicians can draw upon when developing management plans for affected patients.

Target Audience
This continuing education activity is intended for use by health professionals who participate in the care of patients at risk for or suffering from osteoporosis, in the areas of primary care, endocrinology, geriatrics, gynecology, internal medicine, obstetrics, orthopedics, osteopathy, pediatrics, physiatry, radiology, rheumatology and physical therapy.

This includes physicians, nurse practitioners, registered nurses, pharmacists, physician assistants, technologists, researchers, public health professionals and health educators with an interest in osteoporosis and bone health.

Upon completion of this CME material, the participant should be able to:
  • Identify signs and symptoms of vertebral compression fracture (VCF), whether acute, healed, or “silent.”

    Differentiate vertebral compression fractures from other causes of back pain.

    Assess risk for vertebral compression fractures in individual patients.

    Describe the significance of vertebral compression fractures in terms of morbidity and mortality.

    Recognize and rule out non-osteoporosis secondary causes of bone loss and fractures.

The National Osteoporosis Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The National Osteoporosis Foundation designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

The National Osteoporosis Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The National Osteoporosis Foundation designates this educational activity for a maximum of 1.0 continuing nursing education credit(s).

Other healthcare providers will also be able to receive a certificate of completion; nurse practitioners and physician assistants may request an AMA PRA Category 1 Credit(s)™ certificate of participation.

CME Program Eligibility
Method of Participation in the Learning Process: Clinician learners will read and analyze the subject matter, conduct additional informal research through related internet searches on the subject matter, and complete a post-test assessment of knowledge and skills gained as a result of the activity.

After participating in this activity, the reader has the option of taking a post-test with a passing grade of 70% or better to qualify for continuing education credit for this activity. It is estimated it will take 1.0 hour(s) to complete the reading and take the post-test. Continuing education credit will be available for two years from the date of publication.

Disclosure of Commercial Support
It is the policy of the National Osteoporosis Foundation (NOF) to ensure balance, independence, objectivity, and scientific rigor in all its sponsored publications and programs. NOF requires the disclosure of the existence of any significant financial interest or any other relationship the sponsor, Editorial Board or Guest Contributors have with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. All authors and contributors to this continuing education activity have disclosed any real or apparent interest that may have direct bearing on the subject matter of this program.

Please be advised that NOF’s accreditation status with ACCME and ANCC does not imply endorsement by NOF, ACCME or ANCC of any commercial products displayed in conjunction with this activity or endorsement of any point of view.

Statement regarding OFF Label Use

Please be advised that any publication of the Osteoporosis Clinical Updates that discusses off-label use of any medications or devices will be disclosed to the participant.

Refund Policy
NOF offers no returns or refunds on online internet CME activities purchased through our store. All sales are final. Meeting and workshop registrations will be refunded in accordance with the cancellation policy of the meeting and/or workshop, as outlined at registration.

NOF's Osteoporosis: Clinical Updates

Statement of Educational Purpose

The Osteoporosis: Clinical Updates offer valuable information used to improve patient care related to osteoporosis prevention, diagnosis and treatment by providing clinicians with state-of-the-art information and pragmatic strategies that they may apply in clinical practice.

Overall Purpose

In spite of the availability of effective prevention, diagnostic and treatment protocols for osteoporosis, research indicates that osteoporosis is significantly underdiagnosed and undertreated in the general population. NOF encourages participants to increase their knowledge and apply their gained knowledge to the care and treatment of patients with osteoporosis and improver better bone health.

Overall Objectives

Upon completion of each issue of Osteoporosis Clinical Updates, participants should be able to:
• Recognize recent developments related to research and clinical practice of osteoporosis
• Consider how this information will impact their roles in the field of osteoporosis
• Utilize new strategies, based upon evidence-based medicine, to study, prevent and treat osteoporosis
• Improve patient care strategies based upon new data or techniques


Angelo Licata, MD, PhD

Department of Endocrinology
Cleveland Clinic
No disclosures to declare

Adrienne Berarducci, PhD, ARNP, BC
Associate Professor
University of South Florida
No disclosures to declare

Carolyn J. Bolognese, RN, CDE
Clinical Nurse Specialist
Bethesda Health Research Center
No disclosures to declare

JoAnn Caudill, RT, BD, CDT
Imaging Coordinators
Carroll Arthritis, P.A.
No disclosures to declare

Peggy Doheny, PhD, RN, CNS, ONC
Professor Emeritus
Kent State University College of Nursing
No disclosures to declare

Patricia Graham, MD, PC
Physical Medicine and Rehabilitation /Integrative Medicine
No disclosures to declare

Craig Langman, MD
Professor in Pediatrics-Kidney Disease
Northwestern University Feinberg School of Medicine
Consultant: Alexion, Dicerna, Eli Lilly, and Raptor

Barbara Messinger-Rapport, MD, PhD
Medical Director. OPTUM, Complex Population Management
United Health Group
Director, Center for Geriatric Medicine, Cleveland Clinic
No disclosures to declare

Paul D. Miller, MD, FACP
Medical Director
Colorado Center for Bone Research
No disclosures to declare

Jeri Nieves, PhD
Associate Professor of Clinical Epidemiology
Columbia University, Helen Hayes Hospital
No disclosures to declare
Mary Beth O’Connell, PharmD, BCPS
Associate Professor
Eugene Applebaum College of Pharmacy and Health Sciences
Wayne State University
No disclosures to declare

Department of Rheumatology, Western Connecticut Medical Group
Clinical Professor at Quinnipiac and the University of Bridgeport
Faculty: Abbvie, Takeda
Consultant: Medac, Sanofi-Biosurgery

Carol Sedlak, PhD, RN, CNS, ONC, CNE
Professor of Nursing
Director of Nurse Educator Program
Kent State University College of Nursing
No disclosures to declare

Andrea Sikon, MD, FACP, CCD, NCMP
Chair, Department of Internal Medicine & Geriatrics
Cleveland Clinic
No disclosures to declare

Robert Westergan, MD
Medical Director, Orthopaedics, Spine and Musculoskeletal Programs
No disclosures to declare

NOF Clinical Director
Andrea Singer, MD , FACP, CCD

Associate Professor and Chief, Division of Women’s Primary Care
Director of Bone Densitometry,  Department of Obstetrics and Gynecology
Georgetown University Medical School
Consulting: Actavis, Amgen, Eli Lilly, Medtronic, Mission
Speaking/Teaching: Amgen, Actavis
Advisory Committee: Amgen
Research/Grants: Amgen

Managing Editor/Medical Writer
Kelly Trippe, MA

National Osteoporosis Foundation
No disclosures to declare

Lead Nurse Planner
Susan Randall, MSN, RN, FNP-BC

Sr. Director, Science and Education
National Osteoporosis Foundation
No disclosures to declare