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T‐score differences and nonprogression in lumbar vertebrae as predictors of vertebral fractures
Author(s) -
Lajlev Siv E.,
Rejnmark Lars,
Harsløf Torben
Publication year - 2019
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13987
Subject(s) - vertebra , odds ratio , medicine , lumbar vertebrae , thoracic vertebrae , lumbar , significant difference , surgery , anatomy
Abstract Purpose In case of a vertebral fracture, the area of the vertebrae decreases with a concomitant increase in BMD, as assessed by a DXA scanning. Furthermore, a vertebral fracture may disrupt the normal increase in vertebral body area from L1 to L4 (nonprogression). We aimed to examine associations between T‐score difference and nonprogression of vertebral area and vertebral fractures. Methods We identified 100 patients with 1 or more fractures in L1‐L4 and 106 patients without fractures. All patients had undergone a DXA scan and a lumbar spine X‐ray. In fracture patients, we recorded T‐score difference between the fractured vertebra and the adjacent vertebra, and whether the fractured vertebra was smaller than the one above (nonprogression). In nonfracture patients, the greatest positive T‐score difference was recorded, and nonprogression was present if vertebral area did not increase successively from L1 to L4. Results With a T‐score difference ≥1 SD odds ratio for fracture was 1.30 (0.74‐2.29). Sensitivity and specificity were 0.40 and 0.66, respectively. With T‐score difference ≥1.5 SD, odds ratio for fracture was 2.26 (1.08‐4.73). Sensitivity and specificity were 0.24 and 0.88, respectively. Nonprogression was very common in the no‐fracture group (38%), while only 23% of X‐ray verified fractures had nonprogression. Conclusion A randomly found T‐score difference ≥1.5 SD between adjacent vertebrae on a DXA scan is associated with a small increased risk of compression fracture. Nonprogression is very common in patients without fractures.

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