Do Patients Older Than 60 Years With Inflammatory Bowel Disease Have More Vertebral Fractures Than Age-matched Controls? A Study Using Abdominal and Pelvic CT Scans With Sagittal Reformatting as Screening Tool

Abstract

Introduction: It is undetermined whether patients with inflammatory bowel diseases (IBDs) have increased prevalence of vertebral compression fractures (VCFs) since many VCFs are asymptomatic and radiographs may overlook them. We compared the prevalence of VCFs in patients older than 60 years with and without IBDs. Methods: We studied 55 patients with IBDs and 165 controls who underwent CT scans for nonspinal conditions. We evaluated the presence of VCFs, fracture severity using the Genant score, and we determined whether age, sex, diagnosis of IBD, treatment, and time since diagnosis were associated with VCFs. Using logistic regression analysis, we assessed the independent effect of each variable. Results: Mean age was 72.7 years; 165 patients (75%) were women. Thirty-five patients (16%) had at least one VCF (16.4% IBD; 15.8% controls, P = 0.92); both groups exhibited similar fracture severity. Patients with VCFs were older than patients without VCFs (79.8 versus 70.2, P < 0.01 IBD; 76.4 versus 72.4, P = 0.02 controls). No other clinical variables were different in patients with and without VCFs in either cohort. Only age was independently associated with VCFs in both cohorts. Discussion: VCFs were not more frequent or severe in patients older than 60 years with IBD presented than in age-matched controls.

Inflammatory bowel disease is associated with an increased risk of adverse events in patients undergoing joint arthroplasty

“…[9][10][11][12] Additionally, immunomodulatory treatments for IBD may interfere with normal bone metabolism, worsening the risk of osteoporosis, osteonecrosis, and fragility fracture in the elderly. 2,[13][14][15] Due to reduced absorption of micronutrients and uncontrolled inflammation in the gut, patients with IBD often suffer from malnutrition and bone loss, which can be detrimental to rapid postoperative recovery. 16,17 Recently, several studies have been published investigating the potential impact of IBD on postoperative outcomes in patients undergoing joint arthroplasty.…”