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Arch Orthop Trauma Surg · Nov 2019
Incidental identification of vertebral compression fractures in patients over 60 years old using computed tomography scans showing the entire thoraco-lumbar spine.
- Julio Urrutia, Pablo Besa, and Cristobal Piza.
- Department of Orthopaedic Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Diagonal Paraguay 362, Santiago, Chile. jurrutia@med.puc.cl.
- Arch Orthop Trauma Surg. 2019 Nov 1; 139 (11): 1497-1503.
IntroductionVertebral compression fractures (VCF) are frequently asymptomatic; incidental diagnosis is a valuable opportunity to identify low bone mass and to start treatment. We aimed to determine the proportion of patients over 60 years old evaluated with chest plus abdominal and pelvic computed tomography (CT) scans, allowing visualization of the entire thoraco-lumbar spine, who incidentally present VCF.Materials And MethodsWe evaluated 300 patients over 60 years old who under went chest plus abdominal and pelvic CT scans. Using sagittal reformats we looked for VCF using the method described by Genant. Accordingly, VCF were classified into mild, moderate or severe. We also determined the percentage of VCF described in the radiological reports.ResultsIn our cohort [median age 72.5 years (61-94)], 45.67% were males and 54.33% were females. In total, 43 patients (14.33%) had at least one VCF; 32 (10.67%) had one VCF, whereas 11 (3.67%) exhibited multiple VCF, with a total of 84 fractures. 42 were mild fractures, 29 moderate and 13 severe. The proportion of males (13.87%) and females (14.72%) with VCF was not different (p = 0.83). Patients with VCF were older than those without VCF (p < 0.01). Only age but not sex was independently associated with the presence of VCF. Only 32.56% of patients we identified as having a VCF had a description in their report (14 patients).ConclusionAn important proportion of patients over 60 years old evaluated with chest plus abdominal and pelvic CT scans present VCF. The reporting of these VCF is insufficient; radiologists and clinicians should include their detection in their search pattern.
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