Osteoporosis International

, Volume 16, Issue 12, pp 1513–1518

Lateral vertebral assessment: a valuable technique to detect clinically significant vertebral fractures

  • Neil Binkley
  • D. Krueger
  • R. Gangnon
  • H. K. Genant
  • M. K. Drezner
Original Article

DOI: 10.1007/s00198-005-1891-7

Cite this article as:
Binkley, N., Krueger, D., Gangnon, R. et al. Osteoporos Int (2005) 16: 1513. doi:10.1007/s00198-005-1891-7

Abstract

Although many vertebral fractures are clinically silent, they are associated with increased risk for subsequent osteoporotic fractures. A substantial number of these fractures are demonstrable using instant vertebral assessment with Hologic densitometers. Whether similar recognition is possible using dual-energy lateral vertebral assessment (LVA) with GE Lunar densitometers remains uncertain. Thus, we evaluated the ability of clinicians using LVA to detect prevalent vertebral fractures. Dual-energy LVA and conventional thoracic and lumbar spine radiographs were concurrently obtained in 80 postmenopausal women. Using an established visual semiquantitative system, vertebral fractures were identified individually by two non-radiologist clinicians on LVA images, and the results were compared with spinal radiograph evaluation by an expert radiologist. Using LVA, 95% of vertebral bodies from T7 through L4 were evaluable, but a majority (66%) of vertebrae from T4 to T6 were not adequately visualized. In the LVA-evaluable vertebrae, prevalent fractures were identified in 40 vertebral bodies by radiography. In this regard, the clinicians using LVA detected 17 of 18 radiographically evident vertebral fractures of grade 2 or 3, a false negative rate of 6%. They identified 50% (11/22) of grade 1 fractures. Additionally, the vast majority of evaluable non-fractured vertebrae, (764/794, 96.2%) were correctly classified as normal by LVA. Thus, clinicians utilizing LVA correctly identified the vast majority of grade 2 or 3 vertebral compression fractures and normal vertebral bodies, although detection of grade 1 fractures was less effective. In conclusion, the low-radiation, dual-energy LVA technique provides a rapid and convenient way for clinicians to identify patients with, and without, grade 2 or 3 vertebral fractures, thereby enhancing care of osteoporotic patients.

Keywords

Instant vertebral assessment Lateral vertebral assessment Osteoporosis Radiography Vertebral fracture 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  • Neil Binkley
    • 1
    • 4
  • D. Krueger
    • 1
  • R. Gangnon
    • 2
  • H. K. Genant
    • 3
  • M. K. Drezner
    • 1
  1. 1.Osteoporosis Clinical Center and Research ProgramUniversity of WisconsinMadisonUSA
  2. 2.Department of BiostatisticsUniversity of WisconsinMadisonUSA
  3. 3.University of CaliforniaSan FranciscoUSA
  4. 4.MadisonUSA

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