• Yaqi Zong, Yanming Tang, Yuan Xue, Huairong Ding, Zhiyang Li, Dong He, Ying Zhao, and Pei Wang.
• Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Anshan Road No.154, Heping District, Tianjin, 300052, China.
• Eur Spine J. 2016 Nov 1; 25 (11): 3418-3423.

ProposeTo determine whether depression in postmenopausal women with osteoporosis is associated with an increased risk of thoracolumbar fragility fracture.MethodsPostmenopausal women with osteoporosis and without prior vertebral fracture history who were seen at our institution from January 2006 to January 2010 (n = 1397) were divided into depression group (n = 494) and depression-free group (n = 903). After at least 4 years the incidence of thoracolumbar osteoporotic vertebral fracture was compared between the groups. For those who developed vertebral fracture, quality of life over the subsequent 2 months and fracture pain in the subsequent 2 weeks were compared. Depression was assessed with the 21-item Beck Depression Inventory, pain intensity with the visual analogue scale and quality of life with the Medical Outcomes Study 36-item Short-Form Survey.ResultsThe incidence of thoracolumbar fractures among women with continuous depression was higher than the group without depression (35.43 vs. 25.14 %, respectively; (P < 0.05). Osteoporotic thoracolumbar fractures were associated with significantly lower quality of life scores in women with depression than in those without depression (P < 0.05). Fracture pain was experienced by a higher percentage of patients with continuous depression than by those without depression (44.00 vs. 27.31 %; P < 0.05).ConclusionDepression is associated with a higher risk of thoracolumbar fracture, with more fracture pain and with lower quality of life in the 2 months following fracture.

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