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Thoracolumbar kyphosis is associated with compressive vertebral fracture in postmenopausal women

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Abstract

Summary

The main aim of this retrospective cross-sectional study was to examine the relationship between vertebral compression fracture and thoracolumbar Cobb angles. Fracture prevalence was found to be significantly higher for patients with moderate [odds ratio (OR) = 4.78 (2.88–7.95)] or severe kyphosis [OR = 10.7 (5.11–22.40)] than for patients with mild kyphosis. The relationship between degree of thoracolumbar kyphosis and vertebral compression fracture was analyzed.

Introduction

The hypothesis that vertebral compression fracture in women is related to thoracolumbar kyphosis severity was tested, and a clinically important cutoff degree of sagittal thoracolumbar Cobb angle (TLCobb) was determined.

Methods

Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compiled for 212 postmenopausal women with thoracolumbar fracture (study group) and 150 postmenopausal women with degenerative lumbar disease (control group). Group proportions and characteristics were compared with chi-squared tests and unpaired t tests, respectively.

Results

In this retrospective cross-sectional study cohort, 17 patients had T11 fractures, 79 had T12 fractures, 89 had L1 fractures, and 27 had L2 fractures. QCT findings and TLCobb differed between the study and control groups (both p < 0.001). No significant differences were found in body mass index (BMI), disk height, or coronal TLCobb. After adjustment for age, BMI, and QCT findings, fracture prevalence was found to be higher in the thoracolumbar kyphosis study group than in the control group [OR = 6.16, 95% confidence interval (CI) 3.88–9.78]. Sagittal TLCobbs of 7.5–15° and >15° were associated with an increased fracture prevalence, with ORs of 4.78 (2.88–7.95) and 10.7 (5.11–22.40), respectively.

Conclusion

Vertebral fracture prevalence in postmenopausal women was found to be associated with thoracolumbar kyphosis. A TLCobb sagittal angle >15° should be considered an indicator for vertebral fracture assessment.

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References

  1. Lix LM, Azimaee M, Osman BA, Caetano P, Morin S, Metge C, Goltzman D, Kreiger N, Prior J, Leslie WD (2012) Osteoporosis-related fracture case definitions for population-based administrative data. BMC Public Health 12:301

    Article  PubMed  PubMed Central  Google Scholar 

  2. Rouzi AA, Al-Sibiani SA, Al-Senani NS, Radaddi RM, Ardawi MS (2012) Independent predictors of all osteoporosis-related fractures among healthy Saudi postmenopausal women: the CEOR study. Bone Mar 50(3):713–722

    Article  Google Scholar 

  3. Kim BG, Dan JM, Shin DE (2015) Treatment of thoracolumbar fracture. Asian Spine J 9(1):133–146

    Article  PubMed  PubMed Central  Google Scholar 

  4. Sornay-Rendu E, Munoz F, Duboeuf F, Delmas PD (2004) Disc space narrowing is associated with an increased vertebral fracture risk in postmenopausal women: the OFELY study. J Bone Miner Res Dec 19(12):1994–1999

    Article  Google Scholar 

  5. Wood KB, Li W, Lebl DR, Ploumis A (2014) Management of thoracolumbar spine fractures. Spine J 14(1):145–164

    Article  PubMed  Google Scholar 

  6. Yu W, Lin Q, Zhou X, Shao H, Sun P (2014) Reconsideration of the relevance of mild wedge or short vertebral height deformities across a broad age distribution. Osteoporos Int 25(11):2609–2615

    Article  CAS  PubMed  Google Scholar 

  7. American College of Radiology (2008) ACR practice guideline for the performance of quantitative computed tomography bone densitometry. http://www.acr.org/~/media/acr/documents/pgts/guidelines/qct.pdf

  8. Akobeng AK (2007) Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr 96(5):644–647

    Article  PubMed  Google Scholar 

  9. Black DM, Rosen CJ (2016) Clinical practice. Postmenopausal osteoporosis. N Engl J Med 374(3):254–262

    Article  CAS  PubMed  Google Scholar 

  10. Golob AL, Laya MB (2015) Osteoporosis: screening, prevention, and management. Med Clin North Am 99(3):587–606

    Article  PubMed  Google Scholar 

  11. Livshits G, Ermakov S, Popham M, Macgregor AJ, Sambrook PN, Spector TD, Williams FM (2010) Evidence that bone mineral density plays a role in degenerative disc disease: the UK twin spine study. Ann Rheum Dis 69(12):2102–2106

    Article  PubMed  PubMed Central  Google Scholar 

  12. Castaño-Betancourt MC, Oei L, Rivadeneira F, de Schepper EI, Hofman A, Bierma-Zeinstra S, Pols HA, Uitterlinden AG, Van Meurs JB (2013) Association of lumbar disc degeneration with osteoporotic fractures; the Rotterdam study and meta-analysis from systematic review. Bone Nov 57(1):284–289

    Article  Google Scholar 

  13. Schneider DL, Bettencourt R, Barrett-Connor E (2006) Clinical utility of spine bone density in elderly women. J Clin Densitom 9(3):255–260

    Article  PubMed  PubMed Central  Google Scholar 

  14. Guglielmi G, Diacinti D, van Kuijk C, Aparisi F, Krestan C, Adams JE, Link TM (2008) Vertebral morphometry: current methods and recent advances. Eur Radiol 18(7):1484–1496

    Article  CAS  PubMed  Google Scholar 

  15. Hou Y, Luo Z (2009) A study on the structural properties of the lumbar endplate: histological structure, the effect of bone density, and spinal level. Spine (Phila Pa1976) 34(12):E427–E433

    Article  Google Scholar 

  16. Landham PR, Gilbert SJ, Baker-Rand HL, Pollintine P, Robson Brown KA, Adams MA, Dolan P (2015) Pathogenesis of vertebral anterior wedge deformity: a 2-stage process? Spine (Phila Pa 1976) 40(12):902–908

    Article  Google Scholar 

  17. Ailon T, Shaffrey CI, Lenke LG, Harrop JS, Smith JS (2015) Progressive spinal kyphosis in the aging population. Neurosurgery 77(Suppl 4):S164–S172

    Article  PubMed  Google Scholar 

  18. Grigoryan M, Guermazi A, Roemer FW, Delmas PD, Genant HK (2003) Recognizing and reporting osteoporotic vertebral fractures. Eur Spine J 12(Suppl 2):S104–S112

    Article  PubMed  PubMed Central  Google Scholar 

  19. Rajasekaran S, Kanna RM, Shetty AP (2015) Management of thoracolumbar spine trauma: an overview. Indian J Orthop 49(1):72–82

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Bruno AG, Anderson DE, D’Agostino J, Bouxsein ML (2012) The effect of thoracic kyphosis and sagittal plane alignment on vertebral compressive loading. J Bone Miner Res 27(10):2144–2151

    Article  PubMed  PubMed Central  Google Scholar 

  21. van der Jagt-Willems HC, de Groot MH, van Campen JP, Lamoth CJ, Lems WF (2015) Associations between vertebral fractures, increased thoracic kyphosis, a flexed posture and falls in older adults: a prospective cohort study. BMC Geriatr 28:15–34

    Google Scholar 

  22. Nazrun AS, Tzar MN, Mokhtar SA, Mohamed IN (2014) A systematic review of the outcomes of osteoporotic fracture patients after hospital discharge: morbidity, subsequent fractures, and mortality. Ther Clin Risk Manag 10:937–948

    PubMed  PubMed Central  Google Scholar 

  23. Sun G, Tang H, Li M, Liu X, Jin P, Li L (2014) Analysis of risk factors of subsequent fractures after vertebroplasty. Eur spine J. Eur Spine J 23(6):1339–1345

    Article  PubMed  Google Scholar 

  24. Song D, Meng B, Gan M, Niu J, Li S, Chen H, Yuan C, Yang H (2015) The incidence of secondary vertebral fracture of vertebral augmentation techniques versus conservative treatment for painful osteoporotic vertebral fractures: a systematic review and meta-analysis. Acta Radiol 56(8):970–979

    Article  PubMed  Google Scholar 

  25. Bansal S, Katzman WB, Giangregorio LM (2014) Exercise for improving age-related hyperkyphotic posture: a systematic review. Arch Phys Med Rehabil 95(1):129–140

    Article  PubMed  Google Scholar 

  26. Raeissadat SA, Sedighipour L, Pournajaf S, Vahab Kashani R, Sadeghi S (2014) Effect of posture training with weighted kypho-orthosis (WKO) on improving balance in women with osteoporosis. J Aging Res 427903

  27. Jeihooni AK, Hidarnia A, Kaveh MH, Hajizadeh E, Askari A (2015) Effects of an osteoporosis prevention program based on health belief model among females. Nurs Midwifery Stud 4(3):e26731

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hempfing A, Zenner J, Ferraris L, Meier O, Koller H (2011) Restoration of sagittal balance in treatment of thoracic and lumbar vertebral fractures. Orthopade 40(8):690–702

    Article  CAS  PubMed  Google Scholar 

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Acknowledgement

This work was supported by the Fellow of the Royal College of Surgeons (FRCS) Foundation of Beijing JiShuiTan Hospital.

Informed consent

Written informed consent was not required because of the retrospective nature of the investigation.

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Authors and Affiliations

  1. Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, 100035, China

    Y. Wei, W. Tian, G. L. Zhang, Y. W. Lv & G. Y. Cui

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  1. Y. Wei
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  2. W. Tian
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  3. G. L. Zhang
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  4. Y. W. Lv
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  5. G. Y. Cui
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Corresponding author

Correspondence to W. Tian.

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This Health Insurance Portability and Accountability Act-compliant study was approved by the institutional review board of Beijing Jishuitan Hospital.

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None.

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Wei, Y., Tian, W., Zhang, G. et al. Thoracolumbar kyphosis is associated with compressive vertebral fracture in postmenopausal women. Osteoporos Int 28, 1925–1929 (2017). https://doi.org/10.1007/s00198-017-3971-x

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  • DOI: https://doi.org/10.1007/s00198-017-3971-x

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