The Incidence of Vertebral Fractures in Men and Women: The Rotterdam Study

Abstract

Vertebral fractures are considered the most common fractures in osteoporosis. Nevertheless, little is known about the epidemiology of these fractures, especially in men. Therefore, the incidence of vertebral fractures was studied in 3469 men and women from the Rotterdam Study. Spinal radiographs were obtained at baseline and again after a mean follow-up of 6.3 years. The follow-up radiographs were scored for vertebral fractures using the McCloskey-Kanis assessment method. Whenever a vertebral fracture was detected, the radiograph was compared with the baseline radiograph. If this fracture was not already present at baseline, it was considered an incident fracture. The incidence increased strongly with age, ranging from 7.8/1000 person years (PY) at ages 55-65 years to 19.6/1000 PY at ages over 75 years for women, and 5.2-9.3/1000 PY for men, respectively. Analyses repeated in strata of presence or absence of prevalent vertebral fractures showed that both in men and in women, the increase in incidence with age was almost exclusively observed in subjects with one or more prevalent fractures present at baseline. For both genders, the incidence of vertebral fractures doubled per SD decrease in lumbar spine or femoral neck bone mineral density (BMD). This study shows that overall, the incidence of vertebral fractures is higher in women than in men. In both genders, the incidence increases with age. Furthermore, the presence of a prevalent vertebral fracture and a low BMD are strong independent predictors of incident vertebral fractures in men and women. (J Bone Miner Res 2002;17: 1051-1056)

Incidence of vertebral fractures in calcium and vitamin D-supplemented postmenopausal Brazilian women with osteopenia or osteoporosis: data from Arzoxifene Generations Trial

“…This increase in fracture risk is similar to The European Prospective Osteoporosis Study (EPOS) (3), which showed an increase of 3.1 fold in the group aged between 75 to 79 compared to 60 to 64 years. In addition, the results are concordant with the Rotterdam study (16), which found that patients aged 75 years or more had 2.5 fold higher vertebral fracture incidence than the group aged between 55 to 65 years old. These data demonstrate the importance of age as a key determinant of fracture risk.…”

“…It is important to point out, however, that our protocol was designed to include the first event only, refracturing not being taken into account. In the Rotterdam Study, one-fourth of all new fractures were due to refracture (16).…”

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“…The diagnosis of osteoporosis is based on bone mineral density (BMD), preferably measured in the hip and spine. Low BMD independently predicts fracture risk in men (5)(6)(7)(8) and women (9). A Working Group of the WHO has defined osteopenia and osteoporosis in postmenopausal women based on their BMD compared to the mean values observed in young adults (10).…”

Vertebroplasty: benefits are more than risks in selected and evidence-based informed patients. A retrospective study of 59 cases

“…Vertebral fractures are the most common complication of osteopenia [1,2]. Almost 1 million vertebral fractures in the elderly occur each year in Europe, with health costs that amount at 337 million euro [3].…”