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Spine J. 2015 Feb 1;15(2):281-9. doi: 10.1016/j.spinee.2014.09.016. Epub 2014 Sep 28.

Low clinical relevance of a prevalent vertebral fracture in elderly men--the MrOs Sweden study.

Author information

1
Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Stortorget 9, 211 22 Malmo, Sweden. Electronic address: mehrsa.kherad@med.lu.se.
2
Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Stortorget 9, 211 22 Malmo, Sweden.
3
Center for Bone and Arthritis Research, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Sahlgrenska I.C., Box 7163, SE-402 33 Göteborg, Sweden.
4
Geriatric Medicine, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Sahlgrenska I.C., Box 7163, SE-402 33 Göteborg, Sweden.

Abstract

BACKGROUND CONTEXT:

The epidemiology, the fracture pattern, and the clinical relevance of prevalent vertebral fractures in old men are debated wherefore we set out to clarify these issues.

METHODS:

Mister Osteoporosis (MrOs) Sweden is a population-based cohort of community-living men aged 69-81 years that includes 3,014 men. Out of these, 1,453 men underwent a lateral radiograph of the thoracic and lumbar spine of which 1,427 were readable and classified by a radiologist, that is the sample size in this study. The men also answered a questionnaire evaluating back pain and limitation in activities of daily living (ADLs) because of back pain during the preceding 12 months in addition with fracture history and life style.

RESULTS:

Fifteen percentage of the men had at least one prevalent vertebral fracture, but only 1/10th of these were aware of their fracture. Among the men with a fracture, 58% had one, 21% two, 9% three, and 11% four or more fractures. In men with only one fracture, 70% of the fractures were located in the thoracic and 30% in the lumbar spine, 85% had a wedge, 13% a biconcave, and 2% a crush-type configuration; one-quarter had a maximum vertebral body compression degree of less than 24% and one-quarter of more than 38%. Among the men with one or several vertebral fracture, 57% reported back pain compared with 55% in those without a fracture (p=.53). Most ADL functions were similar in the men with or without a prevalent vertebral fracture. In the men with one fracture, there was no difference in the occurrence of back pain depending on the fractured region (p=.49), type of the fracture (p=.77), or degree of compression (p=.85). In men with one or several fractures, there were no significant differences in the presence of back pain in any ages (p=.08), nor there were differences in presence of back pain regarding type (p=.08) or number of fractures (p=.21).

CONCLUSIONS:

A prevalent vertebral fracture is common in old men but has low clinical relevance. There does not seem to be a specific fracture pattern that predisposes for back pain.

KEYWORDS:

Back pain; MrOSstudy; Old men; Population-based cross-sectional study; Vertebrae; Vertebral fracture

PMID:
25264314
DOI:
10.1016/j.spinee.2014.09.016
[Indexed for MEDLINE]

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