Regional Bone Center, Helen Hayes Hospital, Route 9W, West Haverstraw, NY, 10993, USA.
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Osteoporos Int. 2017 Jun;28(6):1857-1866. doi: 10.1007/s00198-017-3948-9. Epub 2017 Feb 7.
Spine fracture prevalence is similar in men and women, increasing from <5 % in those <60 to 11 % in those 70-79 and 18 % in those ≥80 years. Prevalence was higher with age, lower bone mineral density (BMD), and in those meeting criteria for spine imaging. Most subjects with spine fractures were unaware of them.
Spine fractures have substantial medical significance but are seldom recognized. This study collected contemporary nationally representative spine fracture prevalence data.
Cross-sectional analysis of 3330 US adults aged ≥40 years participating in NHANES 2013-2014 with evaluable Vertebral Fracture Assessment (VFA). VFA was graded by semiquantitative measurement. BMD and an osteoporosis questionnaire were collected.
Overall spine fracture prevalence was 5.4 % and similar in men and women. Prevalence increased with age from <5 % in those <60 to 11 % in those 70-79 and 18 % in those ≥80 years. Fractures were more common in non-Hispanic whites and in people with lower body mass index and BMD. Among subjects with spine fracture, 26 % met BMD criteria for osteoporosis. Prevalence was higher in subjects who met National Osteoporosis Foundation (NOF) criteria for spine imaging (14 vs 4.7 %, P < 0.001). Only 8 % of people with a spine fracture diagnosed by VFA had a self-reported fracture, and among those who self-reported a spine fracture, only 21 % were diagnosed with fracture by VFA.
Spine fracture prevalence is similar in women and men and increases with age and lower BMD, although most subjects with spine fracture do not meet BMD criteria for osteoporosis. Since most (>90 %) individuals were unaware of their spine fractures, lateral spine imaging is needed to identify these women and men. Spine fracture prevalence was threefold higher in individuals meeting NOF criteria for spine imaging (∼1 in 7 undergoing VFA). Identifying spine fractures as part of comprehensive risk assessment may improve clinical decision making.
脊柱骨折的患病率在男性和女性中相似，<60 岁的患病率<5%，70-79 岁的为 11%，≥80 岁的为 18%。年龄越大、骨密度（BMD）越低以及符合脊柱影像学检查标准的患者，患病率越高。大多数患有脊柱骨折的患者并未意识到自己患有脊柱骨折。
脊柱骨折具有重要的医学意义，但很少被识别。本研究收集了具有当代代表性的全国脊柱骨折患病率数据。
对 2013-2014 年参加 NHANES 的 3330 名年龄≥40 岁的美国成年人进行横断面分析，这些成年人接受了可评估的椎体骨折评估（VFA）。VFA 通过半定量测量进行分级。收集了 BMD 和骨质疏松症问卷。
总体脊柱骨折患病率为 5.4%，男性和女性患病率相似。患病率随年龄增长而增加，<60 岁的<5%，70-79 岁的为 11%，≥80 岁的为 18%。非西班牙裔白人、体重指数和 BMD 较低的人群中骨折更为常见。在患有脊柱骨折的患者中，26%符合骨质疏松症的 BMD 标准。符合国家骨质疏松基金会（NOF）脊柱影像学检查标准的患者中，患病率较高（14 比 4.7%，P<0.001）。在 VFA 诊断为脊柱骨折的患者中，仅有 8%的人自我报告有骨折，而在自我报告有脊柱骨折的患者中，仅有 21%的人经 VFA 诊断为骨折。
女性和男性的脊柱骨折患病率相似，随年龄和 BMD 降低而增加，尽管大多数患有脊柱骨折的患者不符合骨质疏松症的 BMD 标准。由于大多数（>90%）患者不知道自己有脊柱骨折，因此需要进行脊柱侧位影像学检查来识别这些女性和男性。符合 NOF 脊柱影像学检查标准的患者中，脊柱骨折的患病率高 3 倍（约每 7 例接受 VFA 检查的患者中就有 1 例）。将脊柱骨折识别为综合风险评估的一部分可能会改善临床决策。
