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Osteoporosis International

Published in:

01-10-2007 | Original Article

An evaluation of densitometric vertebral fracture assessment in men

Authors: N. Vallarta-Ast, D. Krueger, C. Wrase, S. Agrawal, N. Binkley

Published in: Osteoporosis International | Issue 10/2007

Abstract

Summary

The utility of, and potential indications for, densitometric vertebral fracture assessment were evaluated in 1,168 men. A bimodal fracture distribution was observed, identifying fractures in 17% of men with no fracture history. Osteopenia or height loss of ≥ 2.5″ may be indications for VFA in men.

Introduction

Densitometric vertebral fracture assessment (VFA) is an excellent means to detect unappreciated vertebral fractures in women. However, little evaluation of VFA in men has been performed. This study evaluated VFA utility and explored potential VFA indications in men.

Methods

The study cohort consists of a population of 1,168 men (mean age, weight and BMI of 69.1 years, 188.8 pounds and 28.1 kg/m², respectively) referred for clinically indicated bone mineral density (BMD) measurement at the Wm. S. Middleton VAMC. Lateral VFA images and scans of the lumbar spine, proximal femur and non-dominant radius, were obtained by two technologists using a GE Healthcare Lunar Prodigy densitometer. Vertebral fractures were defined using the Genant visual semi-quantitative approach.

Results

Seventy-eight percent of vertebrae from T4–L5 and 93% from T8–L5 were adequately visualized on VFA. Vertebral fractures were detected in 32% (374/1,168) of these men. A bimodal distribution was observed with fractures being most common in the mid-thoracic spine and at the thoraco-lumbar junction. As would be expected, the prevalence of VFA-detected fractures increased with age and as BMD declined. Fracture prevalence did not increase until a historical height loss of ≥ 6.4 cm (2.5 inches) was reported. VFA-identified fractures were present in 17% of men who had no history of fracture. Furthermore, in men with densitometric osteopenia, no historical fracture and absence of glucocorticoid use (n = 158), vertebral fractures were detected in 18%.

Conclusion

VFA allows evaluation of the majority of vertebral bodies in men and identifies a substantial number of individuals with previously unappreciated fracture. Additionally, a more stringent height loss requirement, perhaps 2.5 inches or more, or densitometric osteopenia (low bone mineral density by DXA), may be appropriate as indications for performance of VFA in men.

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Title: An evaluation of densitometric vertebral fracture assessment in men
Authors: N. Vallarta-Ast
D. Krueger
C. Wrase
S. Agrawal
N. Binkley
Publication date: 01-10-2007
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 10/2007
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-007-0381-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

An evaluation of densitometric vertebral fracture assessment in men

Abstract

Summary

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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