Comparative supine-sitting lateral radiographs identifying incident osteoporotic vertebral fractures

Abstract

Objective To determine the diagnostic efficacy of comparative supine and sitting lateral radiographs in the diagnosis of incident osteoporotic vertebral fracture (OVF), 41 incident OVF in 38 patients, which had been diagnosed by magnetic resonance imaging, were evaluated. Methods There were 27 female and 11 male patients with the average age of 78 years (range, 54-94 years). Using lateral decubitus-position radiographs, fractures were classified into normal, wedge, biconcave, and crush types, and graded from 0 to 3. Vertebrae showing any measurable changes in the vertebral body height between supine and sitting radiographs were referred to as mobile fractures. Mobile fractures and fixed (nonmobile) fractures were compared with regard to gender and age of patients, location, fracture grade, and the presence of prevalent OVF. The Mann-Whitney U test and the Fisher's exact probability test were used for statistical analysis. Results Of 41 incident OVF, 33 vertebrae (80.5%) showed dynamic mobility in supine and sitting lateral radiographs. Of nine OVF with small deformities (grade 0 or 0.5) and 19 OVF with prevalent OVF, dynamic mobility was seen in six (66.7%) and 15 (78.9%), respectively. Age was significantly higher in patients with mobile fractures than those with fixed fractures. Mobile fractures included a significantly lower percentage of thoracic vertebrae (6%) than of fixed fractures (37.5%). Seven out of eight fixed fractures (87.5%) were grade 1 or less. Conclusions These findings indicate that comparative supine and sitting lateral radiographs are a simple diagnostic procedure for incident OVF available in daily clinics.

Prediction of Treatment Resistance in Conservative Treatment of Osteoporotic Vertebral Fractures Using Lateral Plain Dynamic Loading Radiographs

“…These imaging tests are therefore limited. Meanwhile, lateral plain dynamic loading radiographs obtained in the standing or sitting position (loaded posture) and supine position (nonloaded posture) allow for the evaluation of vertebral body instability [13][14][15][16]. Plain dynamic loading radiography involves taking images of the lateral surface of the vertebral body in both postures and calculating changes in vertebral height between the two.…”