Smorgick Yossi, Pelleg-Kallevag Ruth, Lindner Dror, Anekstein Yoram, Goldstein Sergey, May Hila
Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel.
Department of Orthopedic Surgery Spine Unit, Shamir Medical Center, Be'er Ya'akov, Israel.
Clin Anat. 2025 Jan;38(1):97-104. doi: 10.1002/ca.24219. Epub 2024 Oct 4.
Vertebral osteoporotic fractures (VOF) are among the most frequent fractures in the elderly, often leading to an impaired lifestyle and a high economic burden. Although a reduced bone mass density is considered one of the main risk factors for VOF, its role in determining the fracture type, using the AO spine-DGOU classification for osteoporotic thoracolumbar fractures, as well as its progression, is unknown. The current study aimed to: (1) reveal whether the bone density of the vertebral bodies of fractured and non-fractured vertebrae predicts the type of fracture, (2) examine whether bone density is associated with the initial and progressive collapse of the vertebral body, and (3) provide predictive measures for fracture progression. The study sample included 124 patients (40 males and 84 females) with an acute osteoporotic vertebral fracture who underwent a computerized tomography scan at the time of diagnosis and an x-ray at least 3 months later. The bone density of the fractured and adjacent (non-fractured) vertebrae was measured at diagnosis. The magnitude of the collapse and the progression of the fracture over time were calculated from height measurements of the vertebral bodies at diagnosis and follow-up. Age was a significant factor in predicting the fracture type and magnitude of collapse, whereas sex and bone density were not. The severity of the fracture was involved in predicting its progression, demonstrating that severe-type fractures tended to continue to collapse after diagnosis. However, when each type was examined independently, the density of the fractured vertebra had a protective effect on fracture progression. To conclude, identifying the type of fracture is beneficial in determining patient prognosis. Furthermore, the density of the fractured vertebra, the magnitude of collapse, and patient age are valuable predictors of fracture progression.
椎体骨质疏松性骨折（VOF）是老年人中最常见的骨折之一，常导致生活方式受损和经济负担加重。尽管骨密度降低被认为是VOF的主要危险因素之一，但其在使用AO脊柱-DGOU分类法对骨质疏松性胸腰椎骨折进行骨折类型判定及其进展方面的作用尚不清楚。本研究旨在：（1）揭示骨折椎体和未骨折椎体的骨密度是否能预测骨折类型；（2）检查骨密度是否与椎体的初始塌陷和渐进性塌陷相关；（3）提供骨折进展的预测指标。研究样本包括124例急性骨质疏松性椎体骨折患者（40例男性和84例女性），这些患者在诊断时接受了计算机断层扫描，并在至少3个月后进行了X线检查。在诊断时测量骨折椎体和相邻（未骨折）椎体的骨密度。根据诊断时和随访时椎体高度测量值计算塌陷程度和骨折随时间的进展情况。年龄是预测骨折类型和塌陷程度的重要因素，而性别和骨密度则不是。骨折的严重程度与预测其进展有关，表明严重型骨折在诊断后往往会继续塌陷。然而，当对每种类型进行独立检查时，骨折椎体的密度对骨折进展有保护作用。总之，确定骨折类型有助于判断患者预后。此外，骨折椎体的密度、塌陷程度和患者年龄是骨折进展的重要预测指标。
