Is Sole Lumbar Bone Mineral Density Measurement Sufficient in Postmenopausal Patients with Vertebral Fractures?

Abstract

Purpose: This study aimed to assess the adequacy of using Dual X-ray Absorptiometry (DXA) for evaluating lumbar bone mineral density (BMD) and T-scores in patients with vertebral fragility fractures, without considering thoracic and lumbar X-ray images. Materials and Methods: We conducted a retrospective observational study. Data collected included age, lumbar BMD measure-ments, T-scores, fracture classifications, locations, number of fractures, and radiological artifacts. Patients were grouped based on osteoporosis criteria and the presence of artifacts. Results: Out of 5,393 files, 176 patients with vertebral fractures were analyzed. The osteoporosis group had significantly lower L1-L4 T-scores and total BMD values (p<0.001). Radiological artifacts were more common in the non-osteoporotic group (p<0.001). Fractures were more frequent in the thoracic region for the osteoporosis group, while lumbar fractures were more common in the non osteoporotic group (p=0.027). There was no difference in fracture severity between the groups (p=0.093). In patients with and without radiologic artifacts, the L1-L4 BMD values and T scores did not differ in age groups (p=0.169 ve p=0.452, p=0.980 ve p=0.993). Conclusion: Evaluating lumbar BMD alone is insufficient for post-menopausal vertebral fracture patients. A standardized approach is needed, and further prospective studies are required to confirm these findings.

Keywords

• bone mineral densitometry
• radiologic artifacts
• spinal fractures
• osteoporosis

Postmenopozal Vertebral Fraktürlü Hastalarda Tek Başına Lomber Kemik Mineral Ölçümü Yeterli mi?

Abstract

Amaç: Osteoporoz taraması, takibi amaçlı başvurmuş ve vertebral frajilite kırığı tespit edilmiş hastaların; torakal ve lomber X-ray grafileri dikkate alınmadığında, tek başına Dual X-ray Absorbtiometry (DXA) ile lomber kemik mineral yoğunluğu (KMY) (gr/cm2) ve T skorlarının değerlendirilmesinin, vertebral frajilite kırığı olan bireylerin hastalık yönetiminde yeterliliğinin gösterilmesi hedeflenmiştir. Araçlar ve Yöntem: Bu çalışma retrospektif gözlemsel niteliktedir. Yaş, DXA ile lomber KMY ölçümleri (g/cm2) ve T skorları, kırık sınıflandırılması, kırık yerleşim bölgeleri, sayısı, radyolojik incelemelerinde artefakt varlığı verileri kayıt edildi. Osteoporoz kriterlerini karşılama ve radyolojik artefakt varlığı yönüyle hastalar gruplandırılarak karşılaştırmalar gerçekleştirildi. Bulgular: Toplam 5393 dosya taranarak, vertebral fraktür tespit edilen 176 hasta analizlere dahil edildi. L1-L4 T skoru ve total KMY değerleri osteoporozlu grupta daha düşük bulundu (p<0.001 ve p<0.001). Radyolojk artefaktların osteoporoz olmayan grupta daha fazla olduğu görüldü (p<0.001). Osteoporozlu hastalarda torakal, osteoporozu olmayanlarda ise lomber bölgede kırık sayısı daha fazla bulundu (p=0.027), kırık şiddeti açısından fark saptanmadı (p=0.093). Radyolojik artefakt olan ve olmayan hastalarda; L1-L4 T skoru ve L1-L4 total KMY değerleri açısından yaşa göre farklılık gösterilmedi (p=0.169 ve p=0.452, p=0.980 ve p=0.993). Sonuç: Postmenapozal vertebral fraktürlü hastaların tanı ve takiplerini içeren değerlendirmelerinde, tek başına lomber KMY ölçümü yetersiz bulunmuştur. Klinik hastalık rehberlerinde vertebral fraktürlü hastalar ile ilgili daha net ve standardize edilmiş yaklaşımlara ihtiyaç bulunmaktadır. İleri prospektif randomize kontrollü çalışmaların yapılması gerekmektedir.

Keywords

• kemik mineral dansitometrisi
• radyolojik artefakt
• spinal fraktur
• osteoporoz

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