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Age cited as greatest risk factor of vertebral fractures in patients with spondyloarthropathies
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Age was the greatest risk factor for the occurrence of vertebral fractures in patients with spondyloarthropathy, and most of these fractures were located in the thoracic spine, according to researchers of this study.
Researchers studied data and images from 390 consecutive patients with spondyloarthropathies (SpA) who were evaluated by six rheumatologists. The group included 286 patients with ankylosing spondylitis, 46 patients with undifferentiated SpA, 40 patients with psoriatic arthritis and 18 patients with inflammatory bowel disease. Mean patient age was 47.9 years, the mean onset of symptoms was 14.6 years and 55.1% of all patients were women.
Researchers used dual-energy X-ray absorptiometry to measure bone mineral density (BMD) in the lumbar spine, femoral neck and total hip. The thoracic and lumbar spine were evaluated with lateral radiography and vertebral fracture assessment images. The Genant SQ was used to assign a moderate (grade 2) or severe (grade 3) reduction. Deformities greater than 25% were considered vertebral fractures (grade 2 or 3). The modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) was used to evaluate the total spine, and the cervical, thoracic and lumbar vertebrae on lateral spinal radiographs.
Normal BMD was identified in the spine for 79.7% of patients and in the femoral neck for 59.5% of patients. The average mSASSS was 7.6 in the cervical and lumbar spine, and was 10.6 in the thoracic spine. Moderate-to-severe vertebral fractures were detected in 46 patients, and 20 patients had more than one vertebral fracture. The thoracic spine was the location for 91.2% of the fractures.
Patients with vertebral fractures tended to be older than patients without (52.2 years vs. 47.3 years) and had lower T-scores in the total hip and femoral neck. Significantly higher T-scores in the spine were observed in patients with mSASSS scores above zero.
Multivariate regression analysis showed age as the only significant risk factor for vertebral fractures, with an odds ratio of 1.35 per 10-year increase in age. – by Shirley Pulawski
Disclosures: The researchers report no relevant financial disclosures.
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