Osteoporosis International

, Volume 29, Issue 3, pp 769–772 | Cite as

Rebound-associated vertebral fractures after discontinuation of denosumab for the treatment of maxillitis

  • R. NiimiEmail author
  • T. Kono
  • A. Nishihara
  • M. Hasegawa
  • T. Kono
  • A. Sudo
Case Report


We reported a 69-year-old female who discontinued denosumab due to dental treatment and subsequently suffered rebound-associated vertebral fractures 10 months after the last injection. This case raised an alarm regarding the discontinuation of denosumab for dental treatment. Denosumab, a human monoclonal antibody administered by subcutaneous injection, to the best of our knowledge, is the only fully investigated inhibitor of receptor activator of nuclear factor kappa B ligand. Discontinuation of denosumab leads to bone turnover rebound and rapid bone mineral density loss. Several studies have reported rebound-associated vertebral fractures after discontinuation of denosumab. We report on a new case of rebound-associated vertebral fractures after discontinuation of denosumab. A 69-year-old female, who withdrew from denosumab treatment after 3 years due to maxillitis, presented to our hospital with severe low back pain without any history of trauma. Ten months had passed since the last injection. Magnetic resonance imaging showed five acute vertebral fractures, which appeared to be rebound-associated vertebral fractures caused by discontinuation of denosumab due to dental treatment. This case clearly demonstrates the risk of discontinuation of denosumab for dental treatment.


Denosumab Discontinuation of treatment Rebound-associated vertebral fractures 


Compliance with ethical standards

Conflict of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2017

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryTomidahama HospitalYokkaichi CityJapan
  2. 2.Department of Orthopaedic SurgeryMie University Graduate School of MedicineTsu CityJapan

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