Risk Factors for Subsequent Vertebral Fracture After Acute Osteoporotic Vertebral Fractures

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2021 Jan 30

PMID 33515331

Citations 12

Authors

Hiroyuki Inose

Tsuyoshi Kato

Shoichi Ichimura

Hiroaki Nakamura

Masatoshi Hoshino

Daisuke Togawa

Toru Hirano

Yasuaki Tokuhashi

Tetsuro Ohba

Hirotaka Haro

Takashi Tsuji

Kimiaki Sato

Yutaka Sasao

Masahiko Takahata

Koji Otani

Suketaka Momoshima

Kunihiko Takahashi

Masato Yuasa

Takashi Hirai

Toshitaka Yoshii

Atsushi Okawa

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate the incidence and characteristics of subsequent vertebral fracture after osteoporotic vertebral fractures (OVFs) and identify risk factors for subsequent vertebral fractures.

Methods: This post-hoc analysis from a prospective randomized multicenter trial included 225 patients with a 48-week follow-up period. Differences between the subsequent and non-subsequent fracture groups were analyzed.

Results: Of the 225 patients, 15 (6.7%) had a subsequent fracture during the 48-week follow-up. The annual incidence of subsequent vertebral fracture after fresh OVFs in women aged 65-85 years was 68.8 per 1000 person-years. Most patients (73.3%) experienced subsequent vertebral fractures within 6 months. At 48 weeks, European Quality of Life-5 Dimensions, the Japanese Orthopedic Association Back Pain Evaluation Questionnaire pain-related disorder, walking ability, social life function, and lumbar function scores were significantly lower, while the visual analog scale (VAS) for low back pain was higher in patients with subsequent fracture. Cox proportional hazards analysis showed that a VAS score ≥ 70 at 0 weeks was an independent predictor of subsequent vertebral fracture. After adjustment for history of previous fracture, there was a ~ 67% reduction in the risk of subsequent vertebral fracture at the rigid-brace treatment.

Conclusion: Women with a fresh OVF were at higher risk for subsequent vertebral fracture within the next year. Severe low back pain and use of soft braces were associated with higher risk of subsequent vertebral fractures. Therefore, when treating patients after OVFs with these risk factors, more attention may be needed for the occurrence of subsequent vertebral fractures.

Level Of Evidence: III.

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References

Balasubramanian A, Zhang J, Chen L, Wenkert D, Daigle S, Grauer A . Risk of subsequent fracture after prior fracture among older women. Osteoporos Int. 2018; 30(1):79-92. PMC: 6332293. DOI: 10.1007/s00198-018-4732-1. View

van Geel T, van Helden S, Geusens P, Winkens B, Dinant G . Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis. 2008; 68(1):99-102. DOI: 10.1136/ard.2008.092775. View

Bliuc D, Alarkawi D, Nguyen T, Eisman J, Center J . Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: the Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res. 2014; 30(4):637-46. DOI: 10.1002/jbmr.2393. View

van Staa T, Dennison E, Leufkens H, Cooper C . Epidemiology of fractures in England and Wales. Bone. 2001; 29(6):517-22. DOI: 10.1016/s8756-3282(01)00614-7. View

Lindsay R, Silverman S, Cooper C, Hanley D, Barton I, Broy S . Risk of new vertebral fracture in the year following a fracture. JAMA. 2001; 285(3):320-3. DOI: 10.1001/jama.285.3.320. View

Kato T, Inose H, Ichimura S, Tokuhashi Y, Nakamura H, Hoshino M . Comparison of Rigid and Soft-Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study. J Clin Med. 2019; 8(2). PMC: 6406237. DOI: 10.3390/jcm8020198. View

McCormack H, Horne D, Sheather S . Clinical applications of visual analogue scales: a critical review. Psychol Med. 1988; 18(4):1007-19. DOI: 10.1017/s0033291700009934. View

Fukui M, Chiba K, Kawakami M, Kikuchi S, Konno S, Miyamoto M . JOA Back Pain Evaluation Questionnaire (JOABPEQ)/JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ). The report on the development of revised versions. April 16, 2007. The Subcommittee of the Clinical Outcome Committee of the Japanese.... J Orthop Sci. 2009; 14(3):348-65. DOI: 10.1007/s00776-009-1337-8. View

Keynan O, Fisher C, Vaccaro A, Fehlings M, Oner F, Dietz J . Radiographic measurement parameters in thoracolumbar fractures: a systematic review and consensus statement of the spine trauma study group. Spine (Phila Pa 1976). 2006; 31(5):E156-65. DOI: 10.1097/01.brs.0000201261.94907.0d. View

10.

Genant H, Jergas M, Palermo L, Nevitt M, Valentin R, Black D . Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1996; 11(7):984-96. DOI: 10.1002/jbmr.5650110716. View

11.

Fujiwara S, Kasagi F, Masunari N, Naito K, Suzuki G, Fukunaga M . Fracture prediction from bone mineral density in Japanese men and women. J Bone Miner Res. 2003; 18(8):1547-53. DOI: 10.1359/jbmr.2003.18.8.1547. View

12.

Aubrun F, Langeron O, Quesnel C, Coriat P, Riou B . Relationships between measurement of pain using visual analog score and morphine requirements during postoperative intravenous morphine titration. Anesthesiology. 2003; 98(6):1415-21. DOI: 10.1097/00000542-200306000-00017. View

13.

Kelly A . The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001; 18(3):205-7. PMC: 1725574. DOI: 10.1136/emj.18.3.205. View

14.

Tsuchie H, Miyakoshi N, Kasukawa Y, Nishi T, Abe H, Segawa T . The effect of teriparatide to alleviate pain and to prevent vertebral collapse after fresh osteoporotic vertebral fracture. J Bone Miner Metab. 2015; 34(1):86-91. DOI: 10.1007/s00774-014-0646-y. View

15.

Black D, Thompson D, Bauer D, Ensrud K, Musliner T, Hochberg M . Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. FIT Research Group. J Clin Endocrinol Metab. 2000; 85(11):4118-24. DOI: 10.1210/jcem.85.11.6953. View

16.

Briggs A, Wrigley T, van Dieen J, Phillips B, Lo S, Greig A . The effect of osteoporotic vertebral fracture on predicted spinal loads in vivo. Eur Spine J. 2006; 15(12):1785-95. DOI: 10.1007/s00586-006-0158-0. View

17.

Keller T, Harrison D, Colloca C, Harrison D, Janik T . Prediction of osteoporotic spinal deformity. Spine (Phila Pa 1976). 2003; 28(5):455-62. DOI: 10.1097/01.BRS.0000048651.92777.30. View

18.

Spector E, Smith S, Sibonga J . Skeletal effects of long-duration head-down bed rest. Aviat Space Environ Med. 2009; 80(5 Suppl):A23-8. DOI: 10.3357/asem.br02.2009. View

19.

Lyritis G, Mayasis B, Tsakalakos N, Lambropoulos A, Gazi S, Karachalios T . The natural history of the osteoporotic vertebral fracture. Clin Rheumatol. 1989; 8 Suppl 2:66-9. DOI: 10.1007/BF02207237. View

20.

Buchalter D, Kahanovitz N, Viola K, Dorsky S, Nordin M . Three-dimensional spinal motion measurements. Part 2: A noninvasive assessment of lumbar brace immobilization of the spine. J Spinal Disord. 1988; 1(4):284-6. DOI: 10.1097/00002517-198800140-00001. View