Thoracolumbar kyphosis is associated with compressive vertebral fracture in postmenopausal women

The main aim of this retrospective cross-sectional study was to examine the relationship between vertebral compression fracture and thoracolumbar Cobb angles. Fracture prevalence was found to be significantly higher for patients with moderate [odds ratio (OR) = 4.78 (2.88-7.95)] or severe kyphosis [OR = 10.7 (5.11-22.40)] than for patients with mild kyphosis. The relationship between degree of thoracolumbar kyphosis and vertebral compression fracture was analyzed. The hypothesis that vertebral compression fracture in women is related to thoracolumbar kyphosis severity was tested, and a clinically important cutoff degree of sagittal thoracolumbar Cobb angle (TLCobb) was determined. Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compiled for 212 postmenopausal women with thoracolumbar fracture (study group) and 150 postmenopausal women with degenerative lumbar disease (control group). Group proportions and characteristics were compared with chi-squared tests and unpaired t tests, respectively. In this retrospective cross-sectional study cohort, 17 patients had T11 fractures, 79 had T12 fractures, 89 had L1 fractures, and 27 had L2 fractures. QCT findings and TLCobb differed between the study and control groups (both p < 0.001). No significant differences were found in body mass index (BMI), disk height, or coronal TLCobb. After adjustment for age, BMI, and QCT findings, fracture prevalence was found to be higher in the thoracolumbar kyphosis study group than in the control group [OR = 6.16, 95% confidence interval (CI) 3.88-9.78]. Sagittal TLCobbs of 7.5-15A degrees and > 15A degrees were associated with an increased fracture prevalence, with ORs of 4.78 (2.88-7.95) and 10.7 (5.11-22.40), respectively. Vertebral fracture prevalence in postmenopausal women was found to be associated with thoracolumbar kyphosis. A TLCobb sagittal angle > 15A degrees should be considered an indicator for vertebral fracture assessment.