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Simple x-ray method could help prevent vertebral fractures in older people

By on June 29, 2022 0

In the elderly, vertebral compression fractures are very common and people with such fractures are at high risk of sustaining new ones. The results of a new thesis from the University of Gothenburg indicate that a simple X-ray method should be introduced as a routine procedure in Swedish healthcare. Older patients can then be diagnosed and given the most effective drugs.

Spinal compression means that the spine is compressed, causing one of the vertebrae to fracture. Vertebral compression fractures (VCFs) occur easily in people with osteoporosis and particularly affect older women.

The thesis confirms previous research showing that 25% of women between the ages of 75 and 80 have FVC. However, the majority are unaware that these are causing their back pain – only one in three are diagnosed. According to population statistics from Statistics Sweden (SCB), there are at least 40,000 older women in Sweden who do not know they have VCF.

Diagnostic imaging required

Spinal compressions do not necessarily cause distinct symptoms. Imaging is necessary to detect these vertebral fractures. If more people were diagnosed, many fractures, much suffering and heavy costs could be avoided.

People who have suffered a vertebral compression fracture are more than twice as likely to get a new one, which means they belong to the high-risk group. They should therefore be considered the most effective drugs that not only prevent bones from collapsing, but also strengthen them.”

Lisa Johansson, PhD student at Sahlgrenska Academy, University of Gothenburg, thesis author

Efforts to prevent fractures in the elderly vary across the country. In some areas, but not all, there are “fracture liaison services”, as they are called in Sweden. These ensure that fracture investigations are structured in a way that significantly reduces the risk of repeat fractures. When elderly patients have suffered fractures, their bone density in the hip and lumbar spine is examined with the method of dual-energy X-ray absorptiometry (DXA), to find out whether they need treatment for osteoporosis. DXA can also be used to get a side view of the chest and lumbar spine, with a method called vertebral fracture assessment (VFA), in which the height of the vertebrae is analyzed.

Should be a routine procedure

The thesis shows that AGV has great clinical benefit and the results suggest that the method should be introduced as a routine procedure in healthcare nationwide.

“The VFA method provides a very low dose of radiation, and it is fast, cheap, simple and effective in finding vertebral compressions. It is a valuable method for diagnosing relevant compressions and greatly improves the assessment of fracture risk. in older women,” says Johansson.

The thesis is based on the SUPERB (Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone Fractures) population study, which included 3,028 women in Gothenburg, aged 75-80. The study shows that women with VCF had lower hip bone density and lower physical function and health. Women who had identifiable spinal compression, even if classified as mild, had a markedly increased fracture risk, entirely independent of other risk factors and bone density.