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Location of Vertebral Fractures is Associated with Bone Mineral Density and History of Traumatic Injury

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Abstract

The upper and lower thoracolumbar spine have been associated with different biomechanical outcomes. This concept, as it applies to osteoporotic fracture risk, has not been well documented. This was a case-control study of 120 patients seen in an osteoporosis clinic. Vertebral fractures were identified from lateral radiographs using Genant’s semi-quantitative assessment method. An association between bone mineral density (BMD) T-scores and vertebral fracture location was assessed. In an additional analysis, the association between a history of any traumatic injury and possible predictor variables was also explored. The median age of patients was 75 (IQR 67–80), and 84.2% of patients were female. A history of trauma was reported by 46.7% of patients. A vertebral fracture in the lower thoracolumbar spine (T11–L4) was associated with significantly higher femoral neck (p < 0.001), lumbar (p = 0.005), trochanteric (p = 0.002), intertrochanteric (p < 0.001), and total hip (p = 0.0006) BMD T-scores. The odds of having a femoral neck (OR 0.24, 95% CI 0.07–0.75, p = 0.01) or total hip (OR 0.19, 95% CI 0.06–0.65, p = 0.008) T-score less than −2.5 was also lower among patients with vertebral fractures in the lower thoracolumbar spine. A fracture in the upper thoracolumbar spine (T4–T10) decreased the odds of having a history of traumatic injury (OR 0.32, 95% CI 0.14–0.76, p = 0.01), while a non-vertebral fracture increased the odds of such an injury (OR 2.41, 95% CI 1.10–5.32, p = 0.03). Vertebral fractures in the lower thoracolumbar spine are associated with higher BMD T-scores. This should be studied further to understand possible correlations with patients’ future fracture risk.

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Authors and Affiliations

  1. Division of Geriatric Medicine, University of Toronto, 4-002 Shuter Wing, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

    Jennifer Watt

  2. Division of Geriatric Medicine, University of Western Ontario, London, ON, Canada

    Richard Crilly

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  1. Jennifer Watt
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  2. Richard Crilly
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Correspondence to Jennifer Watt.

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Watt, J., Crilly, R. Location of Vertebral Fractures is Associated with Bone Mineral Density and History of Traumatic Injury. Calcif Tissue Int 100, 412–419 (2017). https://doi.org/10.1007/s00223-017-0244-9

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