Abstract
ObjectiveTo investigate whether thoracolumbar flexion dysfunctions increase the risk of thoracolumbar compression fractures in postmenopausal women.MethodsThe records of postmenopausal women with thoracolumbar vertebral compression fractures and without vertebral compression fractures were surveyed. Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compared between the groups. Chi-squared tests, unpaired t-tests, Spearman, and Mann–Whitney U were used to assess the group characteristics and proportions. The relationship between the risk of fracture and the difference of Cobb’s angle of thoracolumbar segment (DCTL) was evaluated by logistic regression. DCTL was calculated by subtracting thoracolumbar Cobb’s angles (TLCobb’s) from thoracolumbar hyperflexion Cobb’s angles (TLHCobb’s). Quantitative computed tomography (QCT) values and spinal osteoarthritis (OA) of postmenopausal women in the two groups were compared.Results102 of 312 were enrolled to the study group of postmenopausal women with the fracture, and 210 of 312 were enrolled to the control group of postmenopausal women without the fracture. There were significant differences in QCT values and spinal OA including disc narrowing (DSN) and osteophytes (OPH) between the two groups (p < 0.001 for all four). The risk of thoracolumbar compression fractures in the postmenopausal women with DCTL ≤ 8.7° was 9.95 times higher (95% CI 5.31–18.64) than that with > 8.7° after adjusting for age, BMI, and QCT values.ConclusionLow DCTL may be a risk factor of thoracolumbar compression fractures in postmenopausal women, and a DCTL ≤ 8.7° can be a threshold value of thoracolumbar compression fractures.
Highlights
Osteoporotic fracture is a common complication that imposes an enormous medical, psychological, social, and economic cost on individuals, families, and society [1,2,3,4]
The degeneration of intervertebral disc may be one of the contributors of the relationship suggested by Schneider, D.L.et al that disc narrowing is significantly associated with an increased risk of vertebral fracture [16]
A total of 115 postmenopausal women with vertebral compression fracture were selected according to the inclusion criteria, of which 102 postmenopausal women were included in the study group per the exclusion criteria
Summary
Osteoporotic fracture is a common complication that imposes an enormous medical, psychological, social, and economic cost on individuals, families, and society [1,2,3,4]. Thoracolumbar spine, especially on the range from T11 to L2, has the highest incidence of osteoporotic fracture, on which there are most of the fractures in postmenopausal women [4,5,6]. It may be cost-effective to screen from the thoracolumbar spine in postmenopausal women. In the process of increasing the risk of vertebral compression fracture, the degeneration of intervertebral disc may contribute to the formation of spinal flexion dysfunction
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