Weak correlation between osteoporotic-like vertebral fracture severity and densitometric T-scores in older Chinese men.
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ABSTRACT:
SUBMITTER: Wang YXJ
PROVIDER: S-EPMC10477661 | biostudies-literature | 2023 Aug
REPOSITORIES: biostudies-literature
Publications
Weak correlation between osteoporotic-like vertebral fracture severity and densitometric T-scores in older Chinese men.
Wáng Yì Xiáng J YXJ Leung Jason C S JCS Lam Patti M S PMS Kwok Timothy C Y TCY
Annals of translational medicine 20230621 10
Similar Datasets
Project description:ObjectivesTo define what portion of older community men with what severity of radiographic osteoporotic-like vertebral fracture (OLVF) correspond to what low T-score status.MethodsThere were 755 community Chinese men (age: 76.4 ± 6.7 years) with thoracic and lumbar spine radiographs, and hip and lumbar spine bone mineral density measures. For each vertebra in a subject, a score of 0, -0.5, -1, -1.5, -2, -2.5, and -3 was assigned for no OLVF or OLVF of <20%, ≥ 20-25%, ≥ 2 5%-1/3, ≥ 1/3-40%, ≥ 40%-2/3, and ≥ 2/3 vertebral height loss, respectively. OLVFss was defined as the summed score of vertebrae T4 to L5. OLVFss and T-scores were ranked from the smallest to the largest values.ResultsOLVFss of -2, -2.5, -3, corresponded to a mean femoral neck T-score of -2.297 (range: -2.355∼-2.247), -2.494 (range: -2.637∼ -2.363), and -2.773 (range: -2.898∼-2.643), a mean hip T-score of-2.311 (range: -2.420∼-2.234), -2.572 (range: -2.708∼-2.432), -2.911 (range: -3.134∼-2.708), a mean lumbar spine T-score of -2.495 (range: -2.656∼-2.403), -2.931 (range: -3.255∼-2.664), and -3.369 (range: -3.525∼-3.258). The Pearson correlation value of OLVFss and T-score of femoral neck, hip and lumbar spine was r = 0.21, 0.26, and 0.22 (all P < 0.0001).ConclusionsA single severe grade radiological OLVF (≥ 40% height loss) or OLVFss ≤ -2.5 suggest the subject is osteoporotic, and a single collapse grade (≥ 2/3 height loss) OLVF or OLVFss ≤ -3 meets osteoporosis diagnosis criterion. The results highlight the difficulty of diagnosing osteoporotic vertebral fractures among Chinese older men.
| S-EPMC10111950 | biostudies-literature
Project description: Not available
| S-EPMC6517304 | biostudies-literature
Project description:A vertebral deformity (VD) is not always a vertebral fracture (VF). Because of lack of a completely satisfactory "gold standard", there is no consensus on the exact de?nition of a VF. Therefore, it may sometimes be dif?cult, especially in mild cases, to discriminate the prevalent VF from a non-fracture deformity or short vertebral height (SVH). A combined standardized approach based on qualitative and semiquantitative (SQ) vertebral assessment may be the most option to correctly identify a VD as a VF. However this visual approach for VF identi?cation is subjective, therefore it is mandatory an adequate training and experience of radiologist to reach a good sensitivity and speci?city. Vertebral morphometry, objective and reproducible method, could be used only to evaluate the severity of VFs but requires the availability of reference values of vertebral height ratios. There is actually an evidentiary basis for suggesting that a qualitative approach by expert radiologists to morphological vertebral assessment, combined SQ and morphometric methods seem to be the preferred option for the correct diagnosis of VF as endplate or/and cortex fracture (ECF) or severe vertebral height loss.
| S-EPMC6785510 | biostudies-literature
Project description: Not available
| S-EPMC6494647 | biostudies-literature
Project description:We evaluated whether older adults who received kyphoplasty had reduced risk of mortality compared to those who did not. In unmatched analyses, those receiving kyphoplasty were at reduced risk of death but after matching on age and medical complications, patients who received kyphoplasty were at increased risk of death.PurposeIn previous observational studies, kyphoplasty for treatment of osteoporotic vertebral fractures has been associated with decreased mortality compared to conservative management. The purpose of this research was to determine whether older adults who received kyphoplasty had reduced risk of mortality compared to matched patients who did not.MethodsRetrospective cohort study of US Medicare enrollees with osteoporotic vertebral fractures between 2017-2019 comparing patients who underwent kyphoplasty to those who did not. We identified 2 control groups a priori: 1) non-augmented patients who met inclusion criteria (group 1); 2) propensity-matched patients on demographic and clinical variables (group 2). We then identified additional control groups using matching for medical complications (group 3) and age + comorbidities (group 4). We calculated hazard ratios (HRs) and 95% confidence intervals (95% CIs) associated with mortality.ResultsA total of 235,317 patients (mean (± standard deviation) age 81.1 ± 8.3 years; 85.8% female) were analyzed. In the primary analyses, those who received kyphoplasty were at reduced risk of death compared to those who did not: adjusted HR (95% CI) in group 1 = 0.84 (0.82, 0.87); and in group 2 = 0.88 (0.85, 0.91). However, in post hoc analyses, patients who received kyphoplasty were at increased risk of death: adjusted HR (95% CI) in group 3 = 1.32 (1.25, 1.41) and 1.81 (1.58, 2.09) in group 4.ConclusionAn apparent benefit of kyphoplasty on mortality among patients with vertebral fractures was not present after rigorous propensity matching, illustrating the importance of comparing similar individuals when evaluating observational data.
| S-EPMC10718299 | biostudies-literature
Project description: Not available
| S-EPMC6609547 | biostudies-literature
Project description:Vertebral osteoporotic fractures (VOF) are among the most frequent fractures in the elderly, often leading to an impaired lifestyle and a high economic burden. Although a reduced bone mass density is considered one of the main risk factors for VOF, its role in determining the fracture type, using the AO spine-DGOU classification for osteoporotic thoracolumbar fractures, as well as its progression, is unknown. The current study aimed to: (1) reveal whether the bone density of the vertebral bodies of fractured and non-fractured vertebrae predicts the type of fracture, (2) examine whether bone density is associated with the initial and progressive collapse of the vertebral body, and (3) provide predictive measures for fracture progression. The study sample included 124 patients (40 males and 84 females) with an acute osteoporotic vertebral fracture who underwent a computerized tomography scan at the time of diagnosis and an x-ray at least 3 months later. The bone density of the fractured and adjacent (non-fractured) vertebrae was measured at diagnosis. The magnitude of the collapse and the progression of the fracture over time were calculated from height measurements of the vertebral bodies at diagnosis and follow-up. Age was a significant factor in predicting the fracture type and magnitude of collapse, whereas sex and bone density were not. The severity of the fracture was involved in predicting its progression, demonstrating that severe-type fractures tended to continue to collapse after diagnosis. However, when each type was examined independently, the density of the fractured vertebra had a protective effect on fracture progression. To conclude, identifying the type of fracture is beneficial in determining patient prognosis. Furthermore, the density of the fractured vertebra, the magnitude of collapse, and patient age are valuable predictors of fracture progression.
| S-EPMC11652797 | biostudies-literature
Project description:Vertebral augmentation procedures are widely used to treat osteoporotic vertebral compression fractures (VCFs). We report our initial experience with radiofrequency-targeted vertebral augmentation (RF-TVA) in 20 patients aged 50 to 90 years with single-level, symptomatic osteoporotic VCF between T10 and L5, back pain severity >?4 on a 0 to 10 scale, Oswestry Disability Index ??21%, 20% to 90% vertebral height loss compared to adjacent vertebral body, and fracture age <?6 months. After treatment, patients were followed through hospital discharge and returned for visits after 1 week, 1 month, and 3 months. Back pain severity improved 66% (P < 0.001), from 7.9 (95% CI: 7.1 to 8.6) at pretreatment to 2.7 (95% CI: 1.5 to 4.0) at 3 months. Back function improved 46% (P < 0.001), from 74 (95% CI: 69% to 79%) at pretreatment to 40 (95% CI: 33% to 47%) at 3 months. The percentage of patients regularly consuming pain medication was 70% at pretreatment and only 21% at 3 months. No adverse events related to the device or procedure were reported. RF-TVA reduces back pain severity, improves back function, and reduces pain medication requirements with no observed complications in patients with osteoporotic VCF.
| S-EPMC3817678 | biostudies-literature
Project description:Brace is one of the most commonly used interventions to manage osteoporotic vertebral fracture. However, its authentic effectiveness remains unclear. The aim of this study was to investigate the efficacy of brace in patients with osteoporotic vertebral fractures. We conducted a literature review and meta-analysis following the guideline and handbook of the Cochrane collaboration. Ten published articles were included in this study and data from 4 randomized controlled trials were analyzed. Low quality evidence proved using Spinomed brace could bring large and significant beneficial effect to patients with sub-acute osteoporotic vertebral fractures. Very low quality evidence proved no significant difference between Spinomed orthosis, rigid brace and soft brace when they were used in patients with acute fractures. Therefore, it might be applicable to recommend middle term use of Spinomed orthosis to patients with subacute fracture. In addition, this study emphasized the need for high quality randomized controlled trials.
| S-EPMC4999409 | biostudies-literature
Project description:BackgroundBecause of aging of population, osteoporotic vertebral compression fracture (OVCF) appears an increasing incidence rate. Conservative therapy (CT) and balloon kyphoplasty (BKP) have been used to treat OVCFs. However, an increase in new vertebral compression fractures at nontreated levels following BKP is of concern. It is still not clear whether new fractures were a result of BKP and the purpose of this meta-analysis was to evaluate the new fractures risk after BKP compared with CT.MethodsAn exhaustive literature search of PubMed, EMBASE, and the Cochrane Library was conducted to identify randomized controlled trials and prospective nonrandomized controlled study that compared BKP with CT for patients suffering OVCF. A random-effect model was used. Results were reported as standardized mean difference or risk ratio with 95% confidence interval.ResultsTwelve studies were included and there was no significant difference in total new fractures (P = .33) and adjacent fractures (P = .83) between 2 treatments. Subgroup analyses did not demonstrate significant differences in follow-up period, mean age, anti-osteoporosis therapy, and the proportion of women.ConclusionOur systematic review revealed that an increased risk of fracture of vertebral bodies was not associated with BKP compared with CT.
| S-EPMC6200511 | biostudies-literature