Clinical consequences of vertebral fractures

Ross, Philip D.

doi:10.1016/s0002-9343(97)90025-5

Cited by 334 publications

(238 citation statements)

References 72 publications

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“…The mechanism regarding how height loss might be associated with subsequent mortality is not currently well understood. Resulting height loss could affect normal functioning of the respiratory and gastrointestinal systems, (13) which in turn might lead to early satiety, poor nutritional status, and weight loss. (13) Height loss also appears to be related to sarcopenia, (32) which is defined as the loss of skeletal muscle mass and strength with aging and is associated with weight loss (40)(41)(42)(43) and increased mortality.…”

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

“…Resulting height loss could affect normal functioning of the respiratory and gastrointestinal systems, (13) which in turn might lead to early satiety, poor nutritional status, and weight loss. (13) Height loss also appears to be related to sarcopenia, (32) which is defined as the loss of skeletal muscle mass and strength with aging and is associated with weight loss (40)(41)(42)(43) and increased mortality. (33)(34)(35) We found increased mortality associated with marked HL due to CHD or stroke and respiratory diseases, but no increased cancer mortality.…”

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

“…(7,11,12) Kyphosis and height loss are thought to result mainly from underlying vertebral fractures, but have not yet gained much clinical interest other than as markers for osteoporosis. (13)(14)(15)(16)(17)(18) Height loss, however, not only could be caused by vertebral fracture, but also to some extent by intervertebral disk degeneration that decreases disk height; osteoarthritic conditions of the spine, hip, or knee, various inflammatory and structural/congenital spinal deformities; and weakness of the back muscles. (19,20) Our previous report showed that height loss and vertebral deformity significantly and independently affected quality of life (QOL) in the elderly, and height loss aggravated QOL more significantly than did vertebral deformity in all domains, even with different effect patterns between height loss and vertebral deformity.…”

Section: Introductionmentioning

confidence: 99%

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Height loss starting in middle age predicts increased mortality in the elderly

Masunari

Fujiwara

Kasagi

et al. 2011

Journal of Bone and Mineral Research

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The purpose of this study was to determine the mortality risk among Japanese men and women with height loss starting in middle age, taking into account lifestyle and physical factors. A total of 2498 subjects (755 men and 1743 women) aged 47 to 91 years old underwent physical examinations during the period 1994 to 1995. Those individuals were followed for mortality status through 2003. Mortality risk was estimated using an age-stratified Cox proportional hazards model. In addition to sex, adjustment factors such as radiation dose, lifestyle, and physical factors measured at the baseline-including smoking status, alcohol intake, total cholesterol, blood pressure, and diagnosed diseases-were used for analysis of total mortality and mortality from each cause of death. There were a total of 302 all-cause deaths, 46 coronary heart disease and stroke deaths, 58 respiratory deaths including 45 pneumonia deaths, and 132 cancer deaths during the follow-up period. Participants were followed for 20,787 person-years after baseline. Prior history of vertebral deformity and hip fracture were not associated with mortality risk. However, more than 2 cm of height loss starting in middle age showed a significant association with all-cause mortality among the study participants (HR ¼ 1.76, 95% CI 1.31 to 2.38, p ¼ 0.0002), after adjustment was made for sex, attained age, atomic-bomb radiation exposure, and lifestyle and physical factors. Such height loss also was significantly associated with death due to coronary heart disease or stroke (HR ¼ 3.35, 95% CI 1.63 to 6.86, p ¼ 0.0010), as well as respiratory-disease death (HR ¼ 2.52, 95% CI 1.25 to 5.22, p ¼ 0.0130), but not cancer death. Continuous HL also was associated with all-cause mortality and CHD-or stroke-caused mortality. Association between height loss and mortality was still significant, even after excluding persons with vertebral deformity. Height loss of more than 2 cm starting in middle age was an independent risk factor for cardiovascular and respiratory-disease mortality among the elderly, even after adjusting for potential risk factors. ß

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Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Height loss starting in middle age predicts increased mortality in the elderly

Masunari

Fujiwara

Kasagi

et al. 2011

Journal of Bone and Mineral Research

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“…Vertebral fractures are widely considered to be the hallmark of osteoporosis. These fractures are estimated to affect at least 20% of the elderly population [1][2][3]; however, only 30-40% of these come to clinical attention [4,5]. Vertebral fractures have been associated with increased mortality in several studies [6][7][8][9][10][11][12][13], but obvious associations with specific causes of death have so far not been reported.…”

Section: Introductionmentioning

confidence: 99%

Vertebral fracture and cause-specific mortality: a prospective population study of 3,210 men and 3,730 women with 30 years of follow-up

et al. 2011

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Introduction Vertebral fractures predict mortality, but little is known about their associations with the causes of death. We studied vertebral fractures for prediction of cause-specific mortality. Material and methods A nationally representative sample of 3,210 men and 3,730 women participated Mini-Finland health survey in [1978][1979][1980]. Vertebral fractures at the Th1-Th12 levels were identified from chest radiographs at baseline. Cox's proportional hazard model was used to estimate the strength of association between vertebral fracture and mortality. Results The relative risk (95% confidence interval) of death from natural causes was 1.49 (0.89-2.48) in men and 0.89 (0.60-1.31) in women with vertebral fractures (adjusted for age, body mass index, serum 25-hydroxyvitamin D, educational level, smoking, alcohol intake, physical activity and self-rated general health). Among women the adjusted relative risk of an injury death was 8. 51 (3.48-20.77), whereas none of the men with vertebral fracture died due to an injury. Conclusion The patterns of mortality predicted by fracture in the thoracic spine differ between men and women.

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“…They have a prevalence of 8% to 13% among people in their 60s and 30% to 40% among people in their 70s in developed countries [1][2][3][4]. The probability for a 50-year-old woman to develop a fracture during her lifetime is approximately 40% [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Prediction of Treatment Resistance in Conservative Treatment of Osteoporotic Vertebral Fractures Using Lateral Plain Dynamic Loading Radiographs

Funayama¹,

Tsukanishi²,

Abe³

et al. 2017

J Spine

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Purpose: To elucidate the association between computed tomography (CT)/magnetic resonance imaging (MRI) and radiographic findings of fractured vertebral body instability in patients with osteoporotic vertebral fractures and to clarify whether resistance to conservative treatment can be evaluated on the basis of dynamic loading radiography.Methods: Seventy-eight patients aged ≥ 65 years who underwent conservative treatment for osteoporotic single vertebral fractures of the thoracolumbar junction were divided into the conservative treatment-resistant group (18 patients) and control group (60 patients). We evaluated the accuracy of the prediction of resistance to conservative treatment on the basis of the CT/MRI findings and the difference in compression rates between standing and supine positions at the time of the first visit. The differences in compression rates (%) were compared between the two groups. In addition, a receiver operating characteristics (ROC) curve was drawn to evaluate the accuracy of the prediction of resistance to conservative treatment. Results:In patients without (47 cases) and with CT findings (31 cases), the mean differences in compression rates (%) was 8.9% and 19.1%, respectively (p=0.0029). The mean differences in compression rates (%) of patients without (60 cases) and with MRI findings (18 cases) was 9.7% and 24.0%, respectively (p=0.0043). The mean differences in compression rates (%) in the conservative treatment-resistant group was 26.3%, while that in the control group was 9.0 (p=0.0066). In addition, according to the ROC curve of the difference in compression rate was 0.93 (95% confidence interval: 0.87-1), and when a 20% difference in compression rate was considered as the threshold value.Conclusion: Dynamic loading radiography is useful for the evaluation of resistance to conservative treatment in patients with osteoporotic vertebral fractures, and that a compression rate difference of ≥ 20% predicts resistance to conservative treatment.

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Clinical consequences of vertebral fractures

Cited by 334 publications

References 72 publications

Height loss starting in middle age predicts increased mortality in the elderly

Height loss starting in middle age predicts increased mortality in the elderly

Vertebral fracture and cause-specific mortality: a prospective population study of 3,210 men and 3,730 women with 30 years of follow-up

Prediction of Treatment Resistance in Conservative Treatment of Osteoporotic Vertebral Fractures Using Lateral Plain Dynamic Loading Radiographs

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