Hellenic Society for the Study of Bone Metabolism (HSSBM), Thrakis 2, 15124, Athens, Greece.
School of Medicine, Post Graduate Course on Bone Metabolic Diseases, National and Kapodistrian University of Athens, Mikras Asias 75, 11527, Athens, Greece.
Arch Osteoporos. 2021 Nov 4;16(1):165. doi: 10.1007/s11657-021-01033-1.
Our purpose was to assess the prevalence of morphometric vertebral fractures (VFs) in osteoporotic patients in our country. We found that 25.4% of patients had sustained a VF, and the majority of them (76.6%) were undiagnosed prior to inclusion in this study.
We assessed the prevalence of morphometric vertebral fractures (VFs) in osteoporotic patients in our country.
Patients were recruited via announcements by the national media, their attending physicians or the National patients' Society. Inclusion criteria were (1) age > 50 years, (2) postmenopausal status > 2 years (women), (3) > 1-year use of medication for osteoporosis and (4) lack of radiological vertebral assessment for > 1 year. Exclusion criteria were (1) bone metabolic diseases other than osteoporosis, (2) patients with secondary osteoporosis, (3) patients with inability to stand/walk, (4) previous high-energy VFs. All patients performed lateral X-rays of the thoracic and lumbar spine that were evaluated separately both by certified radiologists on site as well as 3 consultant orthopaedic surgeons remotely through a specifically designed web database system. The Genant semi-quantitative method was used for the classification and grading of VFs and statistical analysis of the results was performed.
One thousand six hundred fifty-two patients (1516 female, 70.02 ± 8.28 years; 136 male, 74.78 ± 8.25 years) were included in the final analysis. The prevalence of VFs was 25.4%, 76.6% of fractured patients were previously undiagnosed, and of these 39.9% had > 1 VFs. The most common fracture was T12, most fractures were found to be mild (grade 1) across all age groups, and patients 70-79 years and > 80 years were found to have a statistically significantly higher number of fractures than younger patients (p < 0.001).
Our results of the high prevalence of morphometric VFs emphasise the need for baseline assessment of vertebral fragility in patients receiving treatment for osteoporosis, as well as follow-up radiographs at specified time periods while on therapy.
评估我国骨质疏松患者的椎体骨折（VF）的发生率。我们发现 25.4%的患者发生过 VF，其中大多数（76.6%）在纳入本研究前未被诊断。
通过国家媒体、主治医生或国家患者协会发布通告招募患者。纳入标准为：（1）年龄＞50 岁；（2）绝经＞2 年（女性）；（3）＞1 年应用骨质疏松治疗药物；（4）＞1 年未进行脊柱影像学评估。排除标准为：（1）除骨质疏松外的其他代谢性骨病；（2）继发性骨质疏松症患者；（3）无法站立/行走的患者；（4）既往发生过高能量性 VF 的患者。所有患者均进行了胸腰椎侧位 X 线检查，由现场认证放射科医生以及通过专门设计的网络数据库系统远程的 3 位骨科顾问医师进行单独评估。采用 Genant 半定量方法对 VF 进行分类和分级，并对结果进行统计学分析。
最终有 1652 例患者（1516 例女性，70.02±8.28 岁；136 例男性，74.78±8.25 岁）纳入最终分析。VF 的发生率为 25.4%，76.6%的骨折患者既往未被诊断，其中 39.9%的患者有＞1 个 VF。最常见的骨折部位是 T12，各年龄段的骨折均为轻度（1 级），70-79 岁和＞80 岁的患者与年轻患者相比，骨折数量具有统计学显著差异（p＜0.001）。
我们发现椎体骨折发生率较高，这强调了在治疗骨质疏松症的患者中，基线时评估脊柱脆弱性的必要性，同时还需要在治疗期间的特定时间段进行随访性的 X 线检查。
