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Previous vertebral compression fractures add to the deterioration of the disability and quality of life after an acute compression fracture

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Abstract

Prevalent vertebral compression fracture(s) have been reported as having a negative impact on pain, disability, and quality of life. But no study has evaluated the effect of previous fracture on the course of acute compression fractures. The aim of the present study was to compare the natural course of the acute compression fracture in patients with (n = 51) and without (n = 56) previous vertebral compression fracture(s). The study is a retrospective analysis of a prospective cohort followed with postal questionnaires during a 12-month period after an acute fracture event. Eligible patients were those over 40 years of age, who were admitted to the emergency unit because of back pain and had an X-ray confirmed acute vertebral body fracture. A total of 107 patients were included in the study. The pain, disability (von Korff pain and disability scores), ADL (Hannover ADL score), and quality of life (QoL) (EQ-5D) were measured after 3 weeks, and 3, 6, and 12 months. The X-rays from the first visit to the emergency unit were evaluated. The difference of the scores between the groups with and without previous fracture was statistically significant (P < 0.05) at 3 weeks, 6 and 12 months for von Korff disability score, at all occasions for EQ-5D and at 3–12 months for Hannover ADL score, but only at 12 months for the von Korff pain intensity score. In both the groups all scores had improved in a statistically significant way at 3 months. The number of previous fractures was related to all the outcome scores in a statistically significant way (P < 0.05) except von Korff pain intensity score at 3 weeks and 3 months and von Korff disability score at 3 months. In conclusion, disability, ADL, and QoL scores, but not pain intensity score, were significantly worse in the patients with previous fracture from the fracture episode through the first 12 months. However, the improvements during the follow-up year seen in both groups were of a similar magnitude. The presence or absence of a previous fracture in an acutely fractured patient will influence the prognosis and thus possibly also the indications for treatments.

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Acknowledgments

The study was supported by grants from The Swedish Council for Working Life and Social Research, AFA Insurance, Sahlgrenska academy at Gothenburg University. The study was made possible through the cooperation with the Department of Orthopaedic Surgery, Nagoya City University, Nagoya Japan and its chairman professor Takanobu Otsuka.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-Cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan

    Nobuyuki Suzuki & Osamu Ogikubo

  2. Department of Orthopaedics, Sahlgrenska Academy, Gothenburg University, Bruna Stråket 11, Gothenburg, 413 45, Sweden

    Tommy Hansson

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  1. Nobuyuki Suzuki
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  2. Osamu Ogikubo
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  3. Tommy Hansson
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Correspondence to Tommy Hansson.

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Suzuki, N., Ogikubo, O. & Hansson, T. Previous vertebral compression fractures add to the deterioration of the disability and quality of life after an acute compression fracture. Eur Spine J 19, 567–574 (2010). https://doi.org/10.1007/s00586-009-1162-y

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  • DOI: https://doi.org/10.1007/s00586-009-1162-y

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