Lateral Spine Imaging for Vertebral Fractures May Improve Osteoporosis Detection

The use of lateral spine imaging to detect asymptomatic vertebral fractures in older women may improve osteoporosis identification, according to study results published in The Journal of Bone and Mineral Research.

Researchers conducted a prospective cohort study consisting of 1084 ambulant elderly women with osteopenia who had asymptomatic vertebral fractures that were confirmed with readable lateral spine imaging. Investigators used densitometric lateral spine imaging along with areal bone mineral density testing to evaluate the predictive ability of vertebral fractures to detect fracture hospitalization risk and incident clinical adverse events.

After follow-up analysis, researchers detected fracture-related hospitalization and incident clinical spine fractures in 305 (28%) and 73 (7%) study participants, respectively. In addition, they reported that the relative risk for any incident clinical fracture in patients with baseline vertebral fracture compared with patients without baseline vertebral fracture was 3.46 (95% CI, 2.14-5.60; P <.001).

The primary study limitation was the older study population, which may limit generalizability of the results to younger women.

“At the time of bone density measurement identifying women with prevalent vertebral fractures using low-radiation-dose lateral spine imaging further identifies individuals without osteoporosis who are at high fracture risk,” the researchers wrote.

“Thus, there is strong evidence that once identified, these individuals can reduce their risk with the use of pharmaceutical therapy,” they concluded.

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Reference

Prince RL, Lewis JR, Lim WH, et al. Adding lateral spine imaging for vertebral fractures to densitometric screening: improving ascertainment of patients at high risk of incident osteoporotic fractures [published online November 5, 2018]. J Bone Miner Res. doi:10.1002/jbmr.3595