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Vertebral body morphology is associated with incident lumbar vertebral fracture in postmenopausal women. The OFELY study

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Abstract

Summary

We investigate the predictive role of vertebral anterior cortical curvature and height heterogeneity in the occurrence of vertebral fractures in postmenopausal women. Women who will fracture had shorter vertebral height, greater heterogeneity of height than those who will not fracture, and their anterior vertebral body edge was less concave.

Introduction

Vertebral morphology has been demonstrated to be associated with further risk of fracture. The aim of this study was to analyze vertebral anterior cortical curvature (Ct.curv) and vertebral height heterogeneity in postmenopausal women before the occurrence of a vertebral fracture.

Methods

This case–control study included 29 postmenopausal women who have underwent incident lumbar vertebral fractures (mean age 71 ± 9 years, mean time to fractures 9 ± 4 years), age-matched with 57 controls. From lateral X-rays of lumbar spine radiographs (T12 to L4), the following parameters were measured: (1) the posterior, middle, and anterior vertebral heights; (2) the heterogeneity of heights evaluated by the coefficient of variation of these three variables; (3) antero-posterior width, a 2D estimator of cross-sectional area; and (4) Ct.curv.

Results

Mean vertebral heights were significantly lower among women who fractured than in controls (p < 0.05). The anterior and middle heights were significantly lower at L4 and L3 levels in fracture group (p = 0.02). The heterogeneity of vertebral height was significantly greater in the fracture group (p = 0.003). In addition, fractured patients had a significantly higher Ct.curv on L3 (p = 0.04). After adjustment for bone mineral density (BMD), only the heterogeneity of vertebral height remained significant (p = 0.005).

Conclusion

The current case–control study confirmed the association between vertebral height and occurrence of future vertebral fracture in postmenopausal women. The vertebrae with the smallest Ct.curv tended to fracture less often, and the heterogeneity of vertebral heights was associated with future fracture independently of BMD. An additional validation in a prospective study would be needed to confirm these initial results.

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Author notes

    Authors and Affiliations

    1. INSERM, UMR 1033, Université de Lyon, Lyon, France

      J. P. Roux, S. Belghali, J. Wegrzyn, E. S. Rendu & R. Chapurlat

    2. Department of Orthopedic Surgery–Pavillon T, Hôpital Edouard Herriot, Lyon, France

      J. Wegrzyn

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    1. J. P. Roux
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    2. S. Belghali
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    3. J. Wegrzyn
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    4. E. S. Rendu
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    5. R. Chapurlat
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    Correspondence to J. P. Roux.

    Ethics declarations

    Written informed consent was obtained from each subject, and the study was approved by the local ethics committee.

    Conflict of interest

    Jean-Paul Roux, Safaa Belghali, Julien Wegrzyn, Elisabeth Sornay-Rendu, and Roland Chapurlat declare that they have no conflict of interest.

    Additional information

    J. P. Roux and S. Belghali contributed equally to this work.

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    Roux, J.P., Belghali, S., Wegrzyn, J. et al. Vertebral body morphology is associated with incident lumbar vertebral fracture in postmenopausal women. The OFELY study. Osteoporos Int 27, 2507–2513 (2016). https://doi.org/10.1007/s00198-016-3558-y

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    • DOI: https://doi.org/10.1007/s00198-016-3558-y

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