TY - JOUR
T1 - Risk factors for subsequent vertebral fracture after acute osteoporotic vertebral fractures
AU - Inose, Hiroyuki
AU - Kato, Tsuyoshi
AU - Ichimura, Shoichi
AU - Nakamura, Hiroaki
AU - Hoshino, Masatoshi
AU - Togawa, Daisuke
AU - Hirano, Toru
AU - Tokuhashi, Yasuaki
AU - Ohba, Tetsuro
AU - Haro, Hirotaka
AU - Tsuji, Takashi
AU - Sato, Kimiaki
AU - Sasao, Yutaka
AU - Takahata, Masahiko
AU - Otani, Koji
AU - Momoshima, Suketaka
AU - Takahashi, Kunihiko
AU - Yuasa, Masato
AU - Hirai, Takashi
AU - Yoshii, Toshitaka
AU - Okawa, Atsushi
N1 - Funding Information:
The authors thank Tomoko Nakajima for her help with data collection, Dr. Makoto Tomita for his help with the statistical analysis, and Dr. Ukihide Tateishi for his help with the radiological analysis.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.
PY - 2021/9
Y1 - 2021/9
N2 - Purpose: To investigate the incidence and characteristics of subsequent vertebral fracture after osteoporotic vertebral fractures (OVFs) and identify risk factors for subsequent vertebral fractures. Methods: This post-hoc analysis from a prospective randomized multicenter trial included 225 patients with a 48-week follow-up period. Differences between the subsequent and non-subsequent fracture groups were analyzed. Results: Of the 225 patients, 15 (6.7%) had a subsequent fracture during the 48-week follow-up. The annual incidence of subsequent vertebral fracture after fresh OVFs in women aged 65–85 years was 68.8 per 1000 person-years. Most patients (73.3%) experienced subsequent vertebral fractures within 6 months. At 48 weeks, European Quality of Life-5 Dimensions, the Japanese Orthopedic Association Back Pain Evaluation Questionnaire pain-related disorder, walking ability, social life function, and lumbar function scores were significantly lower, while the visual analog scale (VAS) for low back pain was higher in patients with subsequent fracture. Cox proportional hazards analysis showed that a VAS score ≥ 70 at 0 weeks was an independent predictor of subsequent vertebral fracture. After adjustment for history of previous fracture, there was a ~ 67% reduction in the risk of subsequent vertebral fracture at the rigid-brace treatment. Conclusion: Women with a fresh OVF were at higher risk for subsequent vertebral fracture within the next year. Severe low back pain and use of soft braces were associated with higher risk of subsequent vertebral fractures. Therefore, when treating patients after OVFs with these risk factors, more attention may be needed for the occurrence of subsequent vertebral fractures. Level of evidence: III
AB - Purpose: To investigate the incidence and characteristics of subsequent vertebral fracture after osteoporotic vertebral fractures (OVFs) and identify risk factors for subsequent vertebral fractures. Methods: This post-hoc analysis from a prospective randomized multicenter trial included 225 patients with a 48-week follow-up period. Differences between the subsequent and non-subsequent fracture groups were analyzed. Results: Of the 225 patients, 15 (6.7%) had a subsequent fracture during the 48-week follow-up. The annual incidence of subsequent vertebral fracture after fresh OVFs in women aged 65–85 years was 68.8 per 1000 person-years. Most patients (73.3%) experienced subsequent vertebral fractures within 6 months. At 48 weeks, European Quality of Life-5 Dimensions, the Japanese Orthopedic Association Back Pain Evaluation Questionnaire pain-related disorder, walking ability, social life function, and lumbar function scores were significantly lower, while the visual analog scale (VAS) for low back pain was higher in patients with subsequent fracture. Cox proportional hazards analysis showed that a VAS score ≥ 70 at 0 weeks was an independent predictor of subsequent vertebral fracture. After adjustment for history of previous fracture, there was a ~ 67% reduction in the risk of subsequent vertebral fracture at the rigid-brace treatment. Conclusion: Women with a fresh OVF were at higher risk for subsequent vertebral fracture within the next year. Severe low back pain and use of soft braces were associated with higher risk of subsequent vertebral fractures. Therefore, when treating patients after OVFs with these risk factors, more attention may be needed for the occurrence of subsequent vertebral fractures. Level of evidence: III
KW - Brace treatment
KW - Osteoporotic vertebral fracture
KW - Pain
KW - Subsequent fracture
KW - Visual analog scale
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U2 - 10.1007/s00586-021-06741-3
DO - 10.1007/s00586-021-06741-3
M3 - Article
C2 - 33515331
AN - SCOPUS:85099927265
SN - 0940-6719
VL - 30
SP - 2698
EP - 2707
JO - European Spine Journal
JF - European Spine Journal
IS - 9
ER -