Vertebral Fractures in Osteoporosis: A New Method for Clinical Assessment

doi:10.1385/JCD:3:3:281

Journal of Clinical Densitometry

Volume 3, Issue 3, Autumn 2000, Pages 281-290

https://doi.org/10.1385/JCD:3:3:281 Get rights and content

Abstract

Vertebral fractures are the most common consequence of osteoporosis and are an important risk factor for subsequent fractures. Patients with reduced bone mineral density (BMD) and vertebral fractures have significantly increased risk for future fractures, indicating great potential for the combined use of fracture assessment and BMD in risk evaluation. Despite the established importance of fractures, however, vertebral assessment is not typically performed in the clinical evaluation of patients at risk for osteoporosis. Radiographs are the accepted standard for assessment of fractures but are rarely obtained in osteoporosis assessment for a variety of practical reasons, including cost, radiation dose, and the lack of office-based radiologic facilities. Clinical assessment of fractures is difficult because most are asymptomatic. Consequently, this strong risk factor for osteoporotic fractures is often overlooked. High-resolution lateral spine images, obtained on advanced fan-beam dual X-ray absorptiometry (DXA) systems, provide a practical, low-radiation dose, point-of-care methodology for assessment of vertebral fractures, and have the potential to address this important clinical need. In this article, we review the importance of vertebral fractures and the methods of assessing them. We also review clinical data supporting the feasibility of visual evaluation of lateral spine images obtained using a fan-beam DXA system, and discuss the potential positive impact of this new methodology on clinical patient evaluation.

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Citation Excerpt :
In addition, the combined use of BMD and detection of vertebral fractures appears to improve the assessment of vital risk. For example, Genant's classification (Fig. 5),85 though rarely used by nephrologists,88,89 has proven useful in the general population, and seems to have prognostic utility in patients with CKD89 or on dialysis.88 Currently, vertebral morphometry (“Vertebral Fracture Assessment” or “Lateral Vertebral Acquisition”) can be performed on lateral dorsal-lumbar column images using a densitometer90; the technique has also been used in patients with CKD.91
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Original ArticleVertebral Fractures in Osteoporosis: A New Method for Clinical Assessment

Abstract

Bone

Bone

Bone

Semin Nucl Med

Prevalence and incidence of vertebral fractures

Osteoporos Int

The prevalence of vertebral fracture in European men and women: the European Vertebral Osteoporosis Study

J Bone Miner Res

Risk factors for incidence of vertebral fracture in men and women: 25-year follow-up results from the Framingham Osteoporosis Study

J Bone Miner Res

Low risk of vertebral fracture in Mexican American women

Arch Intern Med

Hospitalization with vertebral fracture among the aged: a national population-based study, 1986–1989

Epidemiology

Pre-existing fractures and bone mass predict vertebral fracture incidence in women

Ann Intern Med

Risk of hip fracture in women with vertebral fracture

J Bone Miner Res

Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women

Osteoporos Int

Vertebral fractures predict subsequent fractures

Osteoporos Int

Prevalent vertebral fractures predict hip fractures and new vertebral fractures but not wrist fractures. Study of Osteoporotic Fractures Research Group

J Bone Miner Res

Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture Intervention Trial Research Group

Arthritis Rheum

Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial

JAMA

Treatment with alendronate prevents fractures in women at highest risk: results from the Fracture Intervention Trial

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Calcif Tissue Int

Predicting the effect of antiresorptive treatments on risk of vertebral fractures: a meta-analysis

J Bone Miner Res

What proportion of incident morphometric vertebral fractures are clinically diagnosed and vice versa?

J Bone Miner Res

Clinical Assessment of Osteoporotic Vertebral Fractures

Contribution of vertebral fractures to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group

J Bone Miner Res

Osteoporosis

Original Article
Vertebral Fractures in Osteoporosis: A New Method for Clinical Assessment