SAN DIEGO — Moderate to severe vertebral compression deformities are uncommon among postmenopausal women with osteopenia who lack a clinical history of fragility fracture, Dr. Angela M. Cheung reported during a poster session at the annual meeting of the International Society for Clinical Densitometry.
In what she described as the first study to describe the prevalence of vertebral deformities in healthy postmenopausal women with osteopenia, Dr. Cheung and her associates conducted a cross-sectional analysis of 439 women participating in the ongoing 2-year Evaluation of the Clinical Use of Vitamin K Supplementation in Postmenopausal Women with Osteopenia trial (ECKO).
Of the 48 deformities detected in the study, 45 (94%) were grade 1.
“The unknown is, how does that mild, grade 1 vertebral compression deformity translate to future fracture risk?” Dr. Cheung, director of the osteoporosis program for the University Health Network, Toronto, said in an interview. “We'll take a look at that. It's an ongoing study.”
Exclusion criteria included being on an osteoporosis medication, having a clinical fragility fracture, or having a T score of less than −2.0 at the lumbar spine, total hip, or femoral neck. Researchers used densitometry to measure bone mineral density and to perform a vertebral fracture assessment.
The mean patient age at baseline was 58 years, and mean body mass index was 26 kg/m
Baseline mean T scores were −1.2 for L1-L4, −0.6 for total hip, and −1.2 for femoral neck.
Baseline vertebral fracture assessment revealed that about 1 in 10 women had at least one vertebral compression deformity. Specifically, 8.7% had a single deformity, and 1.1% had two deformities.
Dr. Cheung said she was surprised to see the presence of vertebral compression deformities in women from all age groups. The age of study participants ranged from 40 to 82 years.
“While we do see a higher percentage of [older] people [with] vertebral compression deformities, we see it in [more] young people, too,” she said. “The gradient is from about 10% in the lowest age group to about 15% in the older age group.”
Two women (aged 56 and 60) had grade 2 deformities while one 74-year-old had a grade 3 deformity.
Limitations acknowledged by the researchers in their poster included the cross-sectional study design and a lack of lateral spine x-rays on the women for comparison.
However, they wrote that vertebral fracture assessment “has been validated by different groups, and the performance of the test is excellent for grades 2–4 deformities.”
While we see more vertebral deformities in older people, we see more in the young, too. DR. CHEUNG
A densitometer image shows a grade 1 L1 vertebral compression deformity. Courtesy Dr. Angela M. Cheung