Summary

The prevalence of unknown vertebral fractures evaluated by systematic vertebral fracture assessment (VFA) was 21% in patients over 50 years of age who suffered from a recent low-trauma non-severe peripheral fracture. The outcome of VFA resulted in changes in the management of osteoporosis.

Introduction

The aim of this study was to evaluate the utility of VFA in detecting vertebral fractures (VFs) in patients over 50 years of age, who suffered from a recent low-trauma non-severe peripheral fracture.

Methods

This was an observational, single-center, cross-sectional study conducted in patients over 50 years of age, who presented a recent low-trauma non-severe peripheral fracture and were identified by the Fracture Liaison Service (FLS) of Amiens University Hospital between December 2017 and March 2019. VFA was interpreted by two trained rheumatologists providing a consensual reading using Genant semi-quantitative assessment.

Results

Of the 359 eligible patients, 114 patients (31.8%) were included (mean age 65.6 ± 8.4 years; 89.5% female). Twenty-four patients (21%) had one or more VF diagnosed by VFA. The total number of VF diagnosed by VFA was 30: 20 VF (66.7%) grade 1, 7 VF (23.3%) grade 2, and 3 VF (10%) grade 3. Among the 24 patients with at least one prevalent VF diagnosed by VFA, 18 patients had an osteoporosis medication adaptation after the VFA results (16 osteoporosis medication initiation and 2 treatment intensification), and 6 patients would have had an osteoporosis medication even without the VFA results (66.7% versus 33.3% respectively, p < 0.001). Of the 51 patients receiving an osteoporosis medication after DXA and VFA, 18 patients (35.3%) had a change in the management of osteoporosis after knowing the outcome of VFA. All the VFs diagnosed by VFA were unknown before. We did not evidence any threshold (age, T-score, height loss) below which no VF was detected.

Conclusions

Our study demonstrates the usefulness of systematic VFA to detect prevalent VF in patients over 50 years of age who suffer from a recent non-severe peripheral fracture.

中文翻译：

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50岁以上非严重周围性骨折的患者的椎骨骨折评估（VFA）。

概要

通过系统性椎体骨折评估（VFA）评估的不明椎体骨折的患病率在50岁以上，近期发生的低创伤，非严重周围性骨折的患者中为21％。VFA的结果导致骨质疏松症管理的改变。

介绍

这项研究的目的是评估VFA在50岁以上患有近期低创伤，非严重周围性骨折的患者中检测椎体骨折（VF）的效用。

方法

这是一项观察性，单中心，横断面研究，研究对象是50岁以上的患者，这些患者最近出现了低创伤性非严重周围性骨折，并被亚眠大学医院的骨折联络处（FLS）确定。 2017年12月和2019年3月。由两名受过训练的风湿病学家对VFA进行解释，并提供使用Genant半定量评估的共识读物。

结果

在359名合格患者中，包括114名患者（31.8％）（平均年龄65.6±8.4岁；女性89.5％）。24名患者（21％）通过VFA诊断出一个或多个VF。由VFA诊断的VF总数为30：1级为20 VF（66.7％），2级为7 VF（23.3％）和3级为3 VF（10％）。在24例至少诊断出一种普遍VF的患者中通过VFA，有18例患者在VFA结果后适应了骨质疏松药物（16例开始使用骨质疏松药物和2例强化治疗），而6例即使没有VFA结果也将接受了骨质疏松药物治疗（分别为66.7％和33.3％，p <0.001）。在接受DXA和VFA治疗后接受骨质疏松症治疗的51例患者中，有18例（35.3％）在了解VFA结局后发生了骨质疏松症治疗的变化。由VFA诊断的所有VF以前都是未知的。我们没有发现任何阈值（年龄，T分数，身高下降），低于该阈值未检测到VF。

结论

我们的研究表明，系统性VFA在检测50岁以上患有近期非严重周围性骨折的患者中检测普遍VF的有用性。