Combined Vertebral Assessment and Bone Densitometry Increases the Prevalence and Severity of Osteoporosis in Patients Referred to DXA Scanning

Mrgan, Monija; Mohammed, Anna; Gram, Jeppe

doi:10.1016/j.jocd.2013.05.002

Cited by 12 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another study focused on Danish females also reported an increase in the number of patients with OP by 9.79 % when VFA and BMD were applied simultaneously [ 26 ]. A survey from northern India showed that the prevalence of VF in healthy community-dwelling men was 24.5 % in the 60–70 year age group and 38.4 % in the 71–80 year age group [ 27 ]. Another recent study focused on postmenopausal women in China found that 62.4 % of patients were diagnosed with OP and the number diagnosed with severe OP increased significantly by 17.2 % based on the combination of VFA and BMD [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

High prevalence of osteoporosis in patients undergoing spine surgery in China

Zhao

Wen

et al. 2021

BMC Geriatr

View full text Add to dashboard Cite

Background With the increase in life expectancy, a large number of patients with osteoporosis (OP) are undergoing spine surgery, which may adversely affect the surgical success rate. The prevalence of OP varies in different regions, and no data are available that represent the prevalence of OP among Chinese patients over 50 years of age who are undergoing spine surgery. It was the first multicenter study to assess OP in these patients. Aiming to obtain comprehensive data, this study combined bone mineral density (BMD) measurements and visual radiography assessment (VRA) to analyze the prevalence of OP in patients aged > 50 years who underwent spine surgery. Methods Data from 1,856 patients aged over 50 years undergoing spine surgery who resided in northern, central, and southern China were reviewed between 2018 and 2019. Based on the perioperative BMD and X-ray data, we calculated the prevalence of OP in this special population according to sex, age, and spine degenerative disease. Results A total of 1,245 patients (678 females and 567 males) were included in the study. The prevalence of OP diagnosed by BMD was 52.8 % in females and 18.7 % in males. When we combined with BMD and VRA, the prevalence of OP increased from 52.8 to 65.9 % in females and from 18.7 to 40.6 % in males. Although OP was more severe in females than in males, a significant difference in the rate of vertebral fracture (VF) was not observed between females and males with a normal BMD and osteopenia (females vs. males: aged 50–59 years, P = 0.977; 60–69 years, P = 0.302; >70 years, P = 0.172). Similarly, no significant difference in the vertebral fracture rate was observed within different age groups of patients with a normal BMD and osteopenia (females: P = 0.210; males, P = 0.895). The incidence of OP in patients with degenerative scoliosis was higher than that in the remaining patients (females: 63.6 % vs. 42.4 %, P = 0.018; males: 38.9 % vs. 13.8 %, P = 0.004). Conclusions A high prevalence of OP was identified in patients aged > 50 years undergoing spine surgery, especially in patients whose primary diagnosis was degenerative scoliosis. BMD and VRA evaluations should be included in the clinical routine for these patients prior to surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

High prevalence of osteoporosis in patients undergoing spine surgery in China

Zhao

Wen

et al. 2021

BMC Geriatr

View full text Add to dashboard Cite

show abstract

“…Many vertebral fractures are already present in patients with a T-score of BMD > − 2.5. Several studies have confirmed that the combination of BMD and vertebral fracture assessment significantly increases diagnostic rate of osteoporosis from 9.8–13.4 and 14.7% for severe osteoporosis [ 15 – 18 ]. The terms “vertebral fracture” and “severe osteoporosis” will likely attract the attention of both orthopedic surgeons and patients.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and under-diagnosis of vertebral fractures on chest radiograph

Yan

Cai

et al. 2018

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundVertebral fracture is the most common fragility fracture but it remains frequently unrecognized and is underdiagnosed worldwide. In this retrospective study, we examined the prevalence of moderate and severe vertebral fractures on chest radiographs of hospitalized female patients aged 50 years and older and determined missed diagnosis of vertebral fractures in the original radiology reports.Methods3216 female patients 50 years of age and older were enrolled in our study. The patients’ medical records including their original radiology reports and lateral chest radiographs were retrospectively reviewed by the study radiologists who had training certificates from the International Society for Clinical Densitometry (ISCD). Vertebral fractures between thoracic spine T4 and lumbar spine L1 were identified and classified using Genant’s semi-quantitative scale. The definition of vertebral fractures used in this study was Genant grade 2 or higher.ResultsThe study radiologists identified 295(9.2%) patients with grade 2 or 3 fractured vertebrae, total 444 vertebrae on 3216 chest radiographs. The prevalence of vertebral fracture was 2.4% in women aged 50-59 yrs., 8.9% in women aged 60–69 yrs., and 21.9% in women aged≥70 yrs. There were 213 patients with a single vertebral fracture, 49 patients with two vertebral fractures and 33 patients with ≥ three vertebral fractures. Fractured vertebrae were identified with greater frequency in thoracic spine T11,12 and lumbar spine L1. According to our statistics, 66.8% of patients with vertebral fractures found in this study were undiagnosed in the original radiology reports.ConclusionsVertebral fracture is common on chest radiographs but it is often ignored by radiologists. Genant’s semiquantitative assessment is a simple and effective method for detecting vertebral fracture. Because osteoporotic vertebral fracture increases the risk of new fractures, radiologists have an important role in accurately diagnosing vertebral fractures.

show abstract

“…The utility of VFA is in the identification of patients who would otherwise not qualify for treatment under the guidelines of the NOF, which are based solely on BMD measurements. Several studies have demonstrated such populations of patients who were reclassified because of vertebral fracture [44][45][46]. The study in the Netherlands demonstrated that 60% of the patients found to have a fracture on VFA were in the nonosteoporotic range, and of these, 74% were previously unknown to have fractures [44].…”

Section: Discussion Of Imaging Modalities By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria ® Osteoporosis and Bone Mineral Density

Ward

Roberts

Bencardino

et al. 2017

Journal of the American College of Radiology

View full text Add to dashboard Cite

Osteoporosis is a considerable public health risk, with 50% of women and 20% of men >50 years of age experiencing fracture, with mortality rates of 20% within the first year. Dual x-ray absorptiometry (DXA) is the primary diagnostic modality by which to screen women >65 years of age and men >70 years of age for osteoporosis. In postmenopausal women <65 years of age with additional risk factors for fracture, DXA is recommended. Some patients with bone mineral density above the threshold for treatment may qualify for treatment on the basis of vertebral body fractures detected through a vertebral fracture assessment scan, a lateral spine equivalent generated from a commercial DXA machine. Quantitative CT is useful in patients with advanced degenerative bony changes in their spines. New technologies such as trabecular bone score represent an emerging role for qualitative assessment of bone in clinical practice. It is critical that both radiologists and referring providers consider osteoporosis in their patients, thereby reducing substantial morbidity, mortality, and cost to the health care system. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

show abstract

Combined Vertebral Assessment and Bone Densitometry Increases the Prevalence and Severity of Osteoporosis in Patients Referred to DXA Scanning

Cited by 12 publications

References 21 publications

High prevalence of osteoporosis in patients undergoing spine surgery in China

High prevalence of osteoporosis in patients undergoing spine surgery in China

The prevalence and under-diagnosis of vertebral fractures on chest radiograph

ACR Appropriateness Criteria ® Osteoporosis and Bone Mineral Density

Contact Info

Product

Resources

About