4.5 Article

Thoracolumbar flexion dysfunction and thoracolumbar compression fracture in postmenopausal women: a single-center retrospective study

Journal

Publisher

BMC
DOI: 10.1186/s13018-021-02857-w

Keywords

Thoracolumbar flexion dysfunction; Vertebral fracture; Osteoporosis; Postmenopausal women; Quantitative computed tomography

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Funding

  1. National Natural Science Foundation of China [81972128]
  2. Medical big data and artificial intelligence of Chinese PLA General Hospital Foundation [2019MBD-022]

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This study found that low DCTL may be a risk factor for thoracolumbar compression fractures in postmenopausal women, and a DCTL <= 8.7 degrees can be a threshold value for thoracolumbar compression fractures.
Objective To investigate whether thoracolumbar flexion dysfunctions increase the risk of thoracolumbar compression fractures in postmenopausal women. Methods The records of postmenopausal women with thoracolumbar vertebral compression fractures and without vertebral compression fractures were surveyed. Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compared between the groups. Chi-squared tests, unpaired t-tests, Spearman, and Mann-Whitney U were used to assess the group characteristics and proportions. The relationship between the risk of fracture and the difference of Cobb's angle of thoracolumbar segment (DCTL) was evaluated by logistic regression. DCTL was calculated by subtracting thoracolumbar Cobb's angles (TLCobb's) from thoracolumbar hyperflexion Cobb's angles (TLHCobb's). Quantitative computed tomography (QCT) values and spinal osteoarthritis (OA) of postmenopausal women in the two groups were compared. Results 102 of 312 were enrolled to the study group of postmenopausal women with the fracture, and 210 of 312 were enrolled to the control group of postmenopausal women without the fracture. There were significant differences in QCT values and spinal OA including disc narrowing (DSN) and osteophytes (OPH) between the two groups (p < 0.001 for all four). The risk of thoracolumbar compression fractures in the postmenopausal women with DCTL <= 8.7 degrees was 9.95 times higher (95% CI 5.31-18.64) than that with > 8.7 degrees after adjusting for age, BMI, and QCT values. Conclusion Low DCTL may be a risk factor of thoracolumbar compression fractures in postmenopausal women, and a DCTL <= 8.7 degrees can be a threshold value of thoracolumbar compression fractures.

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