Prevalence of morphometric vertebral fractures in osteoporotic patients in Greece: the Vertebral Integrity Assessment (VERTINAS) study

Arch Osteoporos. 2021 Nov 4;16(1):165. doi: 10.1007/s11657-021-01033-1.

Abstract

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.

Introduction: We assessed the prevalence of morphometric vertebral fractures (VFs) in osteoporotic patients in our country.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: Ageing; Bone mineral density; Bone strength; Fracture risk; Osteoporosis; Vertebral fracture.

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Bone Density
  • Female
  • Greece / epidemiology
  • Humans
  • Lumbar Vertebrae
  • Male
  • Middle Aged
  • Osteoporotic Fractures* / diagnostic imaging
  • Osteoporotic Fractures* / epidemiology
  • Prevalence
  • Spinal Fractures* / diagnostic imaging
  • Spinal Fractures* / epidemiology