Incidental identification of vertebral compression fractures in patients over 60 years old using computed tomography scans showing the entire thoraco-lumbar spine

• Published in: Archives of orthopaedic and trauma surgery 2019-11, Vol.139 (11), p.1497-1503
• Main Authors: Urrutia, Julio, Besa, Pablo, Piza, Cristobal
• Format: Article
• Language: English
• Subjects: Abdomen; Aged; Aged, 80 and over; Cohort Studies; Female; Fractures; Fractures, Compression - diagnostic imaging; Humans; Lumbar Vertebrae - diagnostic imaging; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Orthopaedic Surgery; Orthopedics; Osteoporosis; Spinal Fractures - diagnostic imaging; Thoracic Vertebrae - diagnostic imaging; Tomography; Tomography, X-Ray Computed
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-019-03177-9

Introduction Vertebral compression fractures (VCF) are frequently asymptomatic; incidental diagnosis is a valuable opportunity to identify low bone mass and to start treatment. We aimed to determine the proportion of patients over 60 years old evaluated with chest plus abdominal and pelvic computed tomography (CT) scans, allowing visualization of the entire thoraco-lumbar spine, who incidentally present VCF. Materials and methods We evaluated 300 patients over 60 years old who under went chest plus abdominal and pelvic CT scans. Using sagittal reformats we looked for VCF using the method described by Genant. Accordingly, VCF were classified into mild, moderate or severe. We also determined the percentage of VCF described in the radiological reports. Results In our cohort [median age 72.5 years (61–94)], 45.67% were males and 54.33% were females. In total, 43 patients (14.33%) had at least one VCF; 32 (10.67%) had one VCF, whereas 11 (3.67%) exhibited multiple VCF, with a total of 84 fractures. 42 were mild fractures, 29 moderate and 13 severe. The proportion of males (13.87%) and females (14.72%) with VCF was not different ( p  = 0.83). Patients with VCF were older than those without VCF ( p