Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 19;19(1):844.
doi: 10.1186/s13018-024-05337-z.

Similarities in distribution pattern between acute multiple osteoporotic vertebral compression fractures and vertebral fractures cascades

Feng Wang  1   2 , Rui Sun  1   2 , Shao-Dong Zhang  1   2 , Xiao-Tao Wu  3   4
Affiliations

Similarities in distribution pattern between acute multiple osteoporotic vertebral compression fractures and vertebral fractures cascades

Feng Wang et al. J Orthop Surg Res. .

Abstract

Backgroud: Osteoporotic vertebral compression fractures (OVCF) cascades (OVCFcs) repeatedly cause vertebral compression to involve multiple vertebra. This study aimed to introduce an accelerated form of OVCFcs: acute multiple OVCF (amOVCF).

Methods: OVCF patients with multiple vertebral augmentations in a spine center between June 2016 and October 2020 were retrospectively studied. Demographics, spine trauma, anatomical distribution, and distribution pattern of OVCF in OVCFcs and amOVCF were summarized and compared.

Results: 429 patients with multiple vertebral augmentations in 1164 vertebra were included. There were 210 OVCFcs accumulating 622 OVCF and 219 amOVCF simultaneously involving 542 vertebra. The OVCFcs progressed at 0.48 fractures and 0.56 vertebra per year. Both OVCFcs and amOVCF demonstrated asymmetrical bimodal distribution in spine and most frequently involved L1. The incidence of adjacent OVCF was 40.14% in amOVCF with 2 OVCF and 84.72% in amOVCF with ≥ 3 OVCF, and the distribution pattern of OVCF was not significantly different between amOVCF and OVCFcs. The female/male ratio was 5.56 in OVCFcs and not different from that of 4.34 in amOVCF. The age of females (73.41 ± 8.08 and 76.29 ± 8.25 years old) but not males (77.20 ± 10.13 and 79.75 ± 10.21 years old) was significantly increased from initial to last OVCF in OVCFcs. amOVCF had similar age (72.26 ± 10.09 years old) as OVCFcs at initial OVCF (73.99 ± 8.51 years old) and were significantly younger than OVCFcs at last OVCF (76.82 ± 8.64 years old). 54.29% in OVCFcs and 48.4% in amOVCF reported no evident trauma, and the ratio of apparent spine trauma was higher in amOVCF (43.38%) than in OVCFcs (28.54%).

Conclusions: amOVCF are accelerated form of OVCFcs showing similar anatomical distribution and distribution pattern of OVCF in spine. Both amOVCF and OVCFcs cause multiple fragility fractures without significant spine trauma.

Keywords: Fragility fracture; Multiple fracture; Osteoporotic vertebral compression fracture; Vertebral fracture cascade.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by Ethic Committee for Clinical Research of Zhongda hospital affiliated to Southeast University (No.2022ZDSYLL016). Consent for publication: The authors affirm that human research participant provided informed consent for publication of the images in Fig. 1. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
OVCFcs and amOVCF. The post-surgery X-ray of OVCFcs (a-c): A 78 years old male experienced initial OVCF and vertebral augmentation in L1 at 72 years old (a). Subsequent OVCF occurred 2.5 years later in L3 (b) and 5.5 years later in L5 (c). The MRI and post-surgery X-ray of amOVCF (d-f): A 72 years old female OVCF showed signal of vertebral marrow edema in L1, L3, and L5 (d: T1-weighted MRI, e: T2-weighted fat suppression MRI). Multiple cement augmentations were performed in the three fractured vertebra (f). OVCF: osteoporotic vertebral compression fractures; OVCFcs: osteoporotic vertebral compression fractures cascades; amOVCF: acute multiple osteoporotic vertebral compression fractures
Fig. 2
Fig. 2
Anatomical distribution of OVCFcs and amOVCF.Both OVCFcs and amOVCF showed asymmetrical bimodal distribution peaked at L1 and T8. OVCF: osteoporotic vertebral compression fractures; OVCFcs: osteoporotic vertebral compression fractures cascades; amOVCF: acute multiple osteoporotic vertebral compression fractures
Fig. 3
Fig. 3
Comparison of age between females and males in OVCFcs and amOVCF. Females were younger than males at initial and last OVCF in OVCFcs. Females and males had similar age in amOVCF. *: P < 0.05, NS: not significantly different. OVCF: osteoporotic vertebral compression fractures; OVCFcs: osteoporotic vertebral compression fractures cascades; amOVCF: acute multiple osteoporotic vertebral compression fractures
Fig. 4
Fig. 4
Comparison of age between amOVCF and OVCFcs at initial and last OVCF. The age of females but not males were significantly increased in OVCFcs from initial to last OVCF. amOVCF had similar age as OVCFcs at initial OVCF. amOVCF were significantly younger than OVCFcs at last OVCF in both females and males. **: P < 0.01, ***:P < 0.005, NS: not significantly different .OVCF: osteoporotic vertebral compression fractures; OVCFcs: osteoporotic vertebral compression fractures cascades; amOVCF: acute multiple osteoporotic vertebral compression fractures
See this image and copyright information in PMC

References

    1. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17(12):1726–33. 10.1007/s00198-006-0172-4. - PubMed
    1. Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Min Res. 2000;15(4):721–39. 10.1359/jbmr.2000.15.4.721. - PubMed
    1. Johansson H, Siggeirsdóttir K, Harvey NC, Odén A, Gudnason V, McCloskey E, Sigurdsson G, Kanis JA. Imminent risk of fracture after fracture. Osteoporos Int. 2017;28(3):775–80. 10.1007/s00198-016-3868-0. - PMC - PubMed
    1. Iconaru L, Moreau M, Baleanu F, Kinnard V, Charles A, Mugisha A, Surquin M, Benoit F, Karmali R, Paesmans M, Body JJ, Bergmann P. Risk factors for imminent fractures: a substudy of the FRISBEE cohort. Osteoporos Int. 2021;32(6):1093–101. 10.1007/s00198-020-05772-8. - PubMed
    1. Briggs AM, Greig AM, Wark JD. The vertebral fracture cascade in osteoporosis: a review of aetiopathogenesis. Osteoporos Int. 2007;18(5):575–84. 10.1007/s00198-006-0304-x. - PubMed

LinkOut - more resources