Spinal fractures in the elderly can be prevented with simple X-rays

Findings in a new thesis from the University of Gothenburg indicate that a simple X-ray method should be introduced as a routine procedure in Swedish health care. More elderly patients can then be diagnosed and given the most efficacious drugs.

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

Few elderly patients who have suffered fractures, their hip and lumbar spine bone density is examined with the dual-energy X-ray absorptiometry (DXA) method, to find out if they need treatment for osteoporosis. Dual-energy X-ray absorptiometry can then 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.

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, between 75 and 80 years old. The study shows that the women with vertebral compression fractures had lower hip bone density to a greater extent, and their physical functional capacity and health was poorer. The women who had an identifiable vertebral compression, even if it was classed as mild, had a markedly increased fracture risk entirely independent from other risk factors and bone density.

The authors said vertebral fracture assessment is of great clinical benefit, and the results suggest that the method should be introduced as a routine procedure in health care nationwide. It provides a very low radiation dose, and it's fast, cheap, simple, and effective in finding vertebral compressions. It's a valuable method for diagnosing relevant compressions, and significantly improves fracture risk assessment in older women

Reference: Defining the clinical usefulness of vertebral fracture assessment https://www.gu.se/en/news/spinal-fractures-in-the-elderly-are-preventable-with-simple-x-rays.