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An MRI scan of the
thoracic and lumbar spine in patients with several AOVFs, or even intuition of
concomitant AOVFs is advised to find out all the acute concomitant fractures.
Oftenly,
numerous fractures on plain radiographs are observed in patients suffering
from osteoporosis who present with an
acute onset of back pain. It is however arduous to differentiate an acute
osteoporotic vertebral fracture (AOVF) from previous fractures. The objective
of the study mentioned here was to examine the prevalence of concomitant AOVFs
and previous OVFs in patients with symptomatic AOVFs, and to recognize risk
factors for concomitant AOVFs.
For
this purpose, 1,005 patients and 2,874 osteoporotic vertebral fractures, which
has been running since February 1, 2006 were taken up from the Registry of
Pathological Osteoporotic Vertebral Fractures (REPAPORA). This was a
prospective epidemiological study in which the concomitant fractures are defined
as at least 2 acute short-tau inversion recovery (STIR-) positive vertebral
fractures that occur concomitantly. A prior fracture is a STIR-negative
fracture at the time of initial diagnostics. To investigate the influence of
various variables on the incidence of concomitant fractures, logistic
regression was used.
It
was revealed that more than 99% of osteoporotic vertebral fractures eventuated
in the thoracic and lumbar spine. Prevalence of concomitant fractures at the
time of first patient contact was 26% and that of prior fractures was 60%. The
odds ratio (OR) for concomitant fractures declined with a higher number of
previous fractures (OR =0.86; p = 0.03) and higher dual-energy X-ray
absorptiometry T-score (OR =0.72; p = 0.003).
It
can thus be interpreted as, concomitant and previous osteoporotic vertebral
fractures are common. As for osteoporotic vertebral fracture, the risk factors
for concomitant fractures are a low T-score and a low number of previous
vertebral fractures. To prevent/reduce the risk of under-diagnosis and
under-treatment, an MRI scan of the the complete thoracic and lumbar spine with
STIR sequence needs to be performed.
Acta Orthopedicia
Concomitant and previous osteoporotic vertebral fractures
Markus Lenski et al.
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