Abstract
To evaluate the usefulness of vertebral morphometry in identifying unreferred vertebral fractures and correlate potential risk factors. Female patients above 45 years, postmenopausal for at least 2 years, diagnosed with osteoporosis and undergoing treatment for at least three months were considered eligible. All of them underwent bone densitometry and vertebral morphometry performed by concomitant DXA. The presence of fractures was defined between T7 and L4; only moderate and severe fractures were considered for analysis. All volunteers were submitted to laboratory tests, anthropometry and responded a questionnaire on their lifestyle habits and medical history. Thirty two (17%) out of the 188 female patients presented with at least one vertebral fracture, among whom only 4 (12.5%) were previously aware of the fracture. The fractures were mainly located on the thoracic spine. Nine patients had severe fractures (28.1%), whereas 23 had moderate fractures (71.9%). On average, patients with fractures were 5 years older and weighed 5 kilograms less than those without fractures. The creatinine clearance was on average 9 mL/min less in patients with vertebral fracture. The assessment of vertebral fractures by morphometry is a fast, accurate and complementary method associated with low radiation exposure for identifying moderate and severe vertebral fractures. Predisposition to vertebral fractures does not depend solely on BMD.
Highlights
Bone fractures are the main cause of morbidity and mortality associated with osteoporosis
The aim of this study was to assess the applicability of digital morphometry performed by vertebral fracture assessment (VFA) in detecting previously undiagnosed vertebral fractures in a population comprised of osteoporosis patients receiving treatment on an outpatient basis
The results showed that morphometry was able to detect moderate or severe vertebral fractures in 17% of such patients, in 87.5% of whom the fracture was unknown
Summary
Bone fractures are the main cause of morbidity and mortality associated with osteoporosis. Fractures of long bones, such as that of the proximal femur, are usually fall-related, causing severe pain and incapacity, which lead patients to seek for immediate medical care. May occur without obvious trauma and be associated with nonspecific symptoms [1]. Most spinal fractures are not clinically recognized at the time they occur: two out of three radiographically detected vertebral fractures are asymptomatic findings [1]. A large proportion of symptomatic fractures are associated with mild pain that tends to disappear in two to three weeks. Even vertebral fractures associated with moderate to severe pain can remain undiagnosed, since there are several other conditions that cause back pain
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