Concomitant and previous osteoporotic vertebral fractures

Figures & data

Figure 1. Examples of single acute, concomitant, and previous fractures. Red: acute fracture; blue: previous fracture. a. 2 previous fractures. b. 1 single acute fracture. c. 2 concomitant fractures. d. 1 acute fracture and 1 previous fracture. e. 3 concomitant fractures and 2 previous fractures.

Figure 2. MRI examples for single acute, concomitant, and previous vertebral fractures. a. Patient no. 1 with T1w and STIR images. b. Patient no. 2 with T2w and STIR images. Blue arrow: single acute fracture; red arrow: previous fracture; white arrow: concomitant fracture.

Figure 3. Location of acute osteoporotic fractures following previous fractures. Red: acute fracture; blue: previous fracture. a. Cranial gap fracture. b. Cranial adjacent fracture. c. Caudal adjacent fracture. d. Caudal gap fracture. e. Pliers fracture.

Table 1. Number of fractures and epidemiology

	n	%
Patients
Acute single fracture	748	74
Concomitant fractures	257	26
Total no. of patients	1,005	100
Fractures
First-time acute single fracture	320	11
Acute single fracture following previous fracture	428	15
Concomitant fractures	640	22
Previous fracture	1,486	52
Total no. of fractures	2,874	100
T-score DXA/qCT
≥ −1.4	9	2
−1.5 to −2.4	21	5
−2.5 to −3.4	160	36
−3.5 to −4.5	135	31
≤ −4.6	116	26
Age, years
64	106	11
65–74	232	23
75–84	414	41
≥ 85	253	25
Gender
Male	254	25
Female	751	75
Mechanism
Spontaneous	664	68
Trauma	311	32
Back pain	646 of 671	96
Sciatica	111 of 646	17
Paresis	23 of 642	4

DXA: dual-energy X-ray absorptiometry;

qCT: quantitative computed tomography.

Table 2. Location of concomitant and previous osteoporotic vertebral fractures (n = 2,874)

Vertebrae of the spine	Acute single fractures	Concomitant fractures	Previous fractures
C1	0	0	0
C2	2	0	1
C3	0	0	0
C4	0	0	1
C5	0	0	0
C6	0	0	1
C7	3	1	2
Sum C1–C7	5 (0%)	1 (0%)	5 (0%)
T1	1	0	7
T2	1	2	8
T3	7	0	9
T4	7	4	14
T5	11	8	31
T6	17	14	45
T7	33	25	82
T8	19	22	80
T9	20	21	56
Sum T1–T9	116 (16%)	96 (15%)	332 (22%)
T10	24	33	56
T11	39	49	124
T12	101	89	178
L1	168	100	212
L2	102	82	170
Sum T10–L2	434 (58%)	353 (55%)	740 (50%)
L3	77	66	146
L4	55	67	147
L5	26	45	97
Sum L3–L5	158 (21%)	178 (28%)	390 (26%)
S1	33	11	18
S2	1	1	1
S3	1	0	0
Sum S1–S3	35 (5%)	12 (2%)	19 (1%)
Sum spine	748	640	1,486

C: cervical; T: thoracic; L: lumbar; S: sacral.

Table 3. Frequency and location of concomitant fractures following previous fractures^a

		No. of concomitant
	Thoracic	Thoracolumbar	Lumbar
	(T1–T9)	(T10–L2)	(L3–L5)
Previous fracture	fractures	fractures	fractures
Thoracic (T1–T9), n	65	99	48
p-value	< 0.01	< 0.01
Thoracolumbar (T10–L2), n	79	238	139
p-value		< 0.01	< 0.01
Lumbar (L3–L5), n	49	160	75
p-value		< 0.01	< 0.01

a Comparison of the number of concomitant fractures in a spinal region after a previous fracture in the thoracic, thoracolumbar, or lumbar spine. The p-values refer to horizontal comparisons