Prevalence and Risk Factors of T-Score Spine-Hip Discordance in Patients with Osteoporotic Vertebral Compression Fracture

Yoon, Byung‐Ho; Kang, Ho Won; Kim, Sumin; Koh, Young Do

doi:10.11005/jbm.2022.29.1.43

Cited by 8 publications

(9 citation statements)

References 28 publications

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“…The main reason may be that the morphological changes of the height or the kyphosis angle after surgery, the sheer force of the adjacent segments is increased, so that leading to increased risks of adjacent vertebral compression fracture. This result was also consistent with previous opinion reported by previous studies [32][33][34][35][36] . Subject to this study, we do not recommend for force the perfect recovery of vertebral height too much in the operation.…”

Section: Discussionsupporting

confidence: 94%

Risk factor analysis of the incidence of adjacent vertebral compression fracture following PKP surgery in postmenopausal women

Wang

Dawei

Bin

et al. 2023

Preprint

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Objective This study aimed to evaluate the risk factors for adjacent vertebral compression fracture following PKP surgery in postmenopausal women. Methods A total of 297 patients who received PKP surgery between January 2016 and December 2020 were divided into two groups according to whether the adjacent vertebral body was fractured. The covariates recorded were age, bone mineral density (BMD), the number of surgical vertebral body, the VAS scores of back, the surgical site (thoracic spine/lumbar spine), the surgical method (unilateral/bilateral), the single section of bone cement volume, the height and the kyphosis angle of the change before and after surgery, the leakage of bone cement. A one-way ANOVA was performed with the above mentioned parameters and binary logistic regression analysis was used to determine the relative risk factors. Results A total of 297 patients were followed-up at a mean of 2.1 ± 0.4 years (range,2–3years). Sixty-seven patients demonstrated fractures in the adjacent vertebral body following surgery. Analysis by one-way ANOVA demonstrated that the age(p = 0.001), the bone mineral density (BMD)(p = 0.000), the number of surgical vertebral body(p = 0.014), the VAS scores of back(p = 0.000), the surgical site (thoracic spine/lumbar spine)(p = 0.001), the single section of bone cement volume(p = 0.034), the height of change after surgery(p = 0.000) and the kyphosis angle of change after surgery(p = 0.000) were potential risk factors (all parameters, p<0.05). Furthermore, binary logistic regression analysis showed that the age(OR = 4.022, 95%CI 1.348–12.002, p = 0.013), the BMD(OR = 2.008, 95%CI 1.465–2.754, p = 0.000), the VAS scores of back(OR = 1.472, 95%CI 1.135–1.909, p = 0.004), the change of height after operation(OR = 0.181, 95%CI 0.089–0.367, p = 0.000) and the change of kyphosis angle after operation(OR = 0.806, 95%CI 0.689–0.943, p = 0.007) were also risk factors for adjacent vertebral compression fractures following PKP surgery in postmenopausal women. Conclusions The age, the BMD, the VAS scores of back, the change of height after operation and the change of kyphosis angle after operation may be risk factors for fractures in the adjacent vertebral body of postmenopausal women following PKP surgery.

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Section: Discussionsupporting

confidence: 94%

Risk factor analysis of the incidence of adjacent vertebral compression fracture following PKP surgery in postmenopausal women

Wang

Dawei

Bin

et al. 2023

Preprint

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“…[ 9 ] Otherwise, our previous study showed that LS discordance was main pattern (81.3%) in patients with an osteoporotic vertebral compression fracture. [ 10 ] It is notable because T-score of the spine is usually higher than that of the hip in the elderly over 70 years of age due to degenerative changes. [ 15 , 19 ] Considering the above results, clinicians need to know the possibility of discordance and type to predict osteoporotic fracture.…”

Section: Discussionmentioning

confidence: 99%

“…[ 9 ] Thus it seems to be there are differences in pattern of discordance according to the fracture site or type. [ 10 ]…”

Section: Introductionmentioning

confidence: 99%

“…[9] Thus it seems to be there are differences in pattern of discordance according to the fracture site or type. [10] Studies on the prevalence and factors of T-score discordance in Korea are still lacking, and no studies have examined discordance of AFFs when compared with patients who were treated with osteoporotic femur neck fracture (FNF). The aim of current study is to compare the prevalence and risk factors of SHD between patients with AFF and FNF from a single tertiary orthopedic institution.…”

Section: Introductionmentioning

confidence: 99%

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Different Pattern of T-Score Discordance between Patients with Atypical Femoral Fracture and Femur Neck Fracture

et al. 2023

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Background: Our study evaluated the prevalence and pattern of T-score discordance between the spine and hip in Korean patients with atypical femoral fracture (AFF) and femur neck fracture (FNF).Methods: A total of 49 patients (all women) who were treated for AFF and 1:3 matched 147 female patients with FNF were included from January 2012 to August 2022. A discordance of more than 1.5 between lumbar spine and femur neck bone mineral density (BMD) was defined as a difference and divided into 3 groups: lumbar low (LL; lumbar BMD is less than femur neck BMD), no discordance (ND), and femur neck low (FL; femur neck BMD is less than lumbar BMD). We compared the prevalence and pattern of discordance between 2 groups, and the associated risk factors of T-score discordance among the subjects were evaluated using regression analysis.Results: The prevalence of discordance was significantly higher in patients with AFF (51%) than in those with FNF (25.2%; <i>p</i><0.001). LL discordance was found in 46.9% of the patients with AFF but only 4.8% in those with FNF. Conversely, FL discordance was found in 4.1% of the patients with AFF and 20.4% in those with FNF, respectively. No specific risk factor was found as T-score discordance in the 2 groups.Conclusions: Clinicians should be aware that the pattern of T-score discordance can vary depending on the location of osteoporotic fractures. In addition, a longitudinal study would be necessary to verify the pattern of T-score discordance related to the osteoporotic fracture location.

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“…Following this epidemiology study, multiple studies have reported a high prevalence of T -score discordance in populations with different ethnicities. 5 – 7 They have also attempted to identify the contributing factors. However, studies have only considered basic demographic data (e.g., age, sex, and body weight) and patient clinical history (e.g., menopause or smoking) and may have overlooked other variables that are highly correlated with bone health, such as muscle power, visceral adiposity percentage, and walking speed.…”

Section: Introductionmentioning

confidence: 99%

T-score discordance between hip and lumbar spine: risk factors and clinical implications

Chiang

Jang

Chen

et al. 2023

Therapeutic Advances in Musculoskeletal

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Background: T-score discordance is common in osteoporosis diagnosis and leads to problems for clinicians formulating treatment plans. Objectives: This study investigated the potential predictors of T-score discordance and compared fracture risk among individuals with varying T-score discordance status. Design: This was a single-center cross-sectional study conducted at Wan Fang Hospital, Taipei City, between 1 February 2020 and 31 January 2022. Methods: The present study enrolled patients aged ⩾50 years who received advanced bone health examination. Participants with a history of fracture surgery or underlying musculoskeletal diseases were excluded. Bioelectrical impedance analysis and dual-energy X-ray absorptiometry were used to determine the body composition and T-score, respectively. Discordance was defined as different T-score categories between the lumbar spine and hip. The impact of discordance on an individual’s fracture risk was assessed using the Fracture Risk Assessment Tool (FRAX). Results: This study enrolled 1402 participants (181 men and 1221 women). Of the 912 participants diagnosed with osteoporosis, 47 (5%) and 364 (40%) were categorized as having major and minor discordance, respectively. Multinomial logistic regression revealed that decreased walking speed was significantly correlated with major discordance but not osteoporosis in both the hip and lumbar spine (odds ratio of 0.25, p = 0.04). The adjusted FRAX scores for the major osteoporotic fracture risks of the major and minor discordance groups were approximately 14%, which was significantly lower than that of people having osteoporosis in both the hip and lumbar spine. Conclusions: Walking speed exhibited the most significant correlation with major discordance in patients with osteoporosis. Although adjusted major fracture risks were similar between the major and minor discordance groups, further longitudinal studies are warranted to confirm this finding. Registrations: This study was approved by the Ethics Committee of Taipei Medical University on 01/04/2022 (TMU-JIRB N202203088).

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Prevalence and Risk Factors of T-Score Spine-Hip Discordance in Patients with Osteoporotic Vertebral Compression Fracture

Cited by 8 publications

References 28 publications

Risk factor analysis of the incidence of adjacent vertebral compression fracture following PKP surgery in postmenopausal women

Risk factor analysis of the incidence of adjacent vertebral compression fracture following PKP surgery in postmenopausal women

Different Pattern of T-Score Discordance between Patients with Atypical Femoral Fracture and Femur Neck Fracture

T-score discordance between hip and lumbar spine: risk factors and clinical implications

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