93 Does Spinal Bone Mineral Density Predict An Absolute 10 Year Probability of Sustaining A Major Osteoporotic Fracture

Spine and hip bone mineral density (BMD) have previously been shown to predict the risk of sustaining future fractures. Although these have been shown in population studies, there is a paucity of trials looking at the relationship between BMD and 10 year probability of major osteoporotic fractures (Using FRAX UK without BMD) in patients with previous fragility fractures. Aims To evaluate the correlation between spinal T-score and an absolute 10 year probability of sustaining a major osteoporotic fracture (using FRAX without BMD) in patients with prior fragility fractures. Methods A retrospective cross-sectional analysis of 202 patients (29 males and 173 females) with prior fragility fractures attending a fracture prevention clinic between January and August 2019 was performed. Patients with pathological and high impact traumatic fractures were excluded. The BMD at the spine was determined using the lowest T-score of the vertebrae from L1 to L4. Using the FRAX (UK) without BMD, the absolute 10 year probability of sustaining a major osteoporotic fracture was calculated for each patient. Statistical analysis was performed using SPSS 26 software. Results The mean T-score at the spine was −1.15 (SD +/− 1.90) for all patients, −0.68 (SD +/− 0.45) for males and − 1.23 (SD +/− 0.14) for females. The mean FRAX score without BMD for major osteoporotic fracture was 18.5% (SD +/− 8.84) for all patients, 11.41% (SD +/−0.62) and 19.7% (SD +/−0.68) for males and females respectively. Pearson correlation coefficient showed a statistically significant, slightly negative correlation between spinal T- score and the FRAX (UK) without BMD (r = −0.157; p < 0.05). Correlation was not statistically significant when males (r = 0.109; p = 0.59) and females (r = 0.148; p = 0.053) were considered independently. Conclusion In patients with prior fragility fracture spinal BMD has a statistically significant negative correlation with an absolute 10 year probability of sustaining a major osteoporotic fracture.