Prevalence of vertebral compression fracture deformity by X-ray absorptiometry of lateral thoracic and lumbar spines in a population referred for bone densitometry.

The presence of a vertebral compression fracture has been demonstrated to be a predictor of future fracture independent of bone mineral density in prospective cohort studies. Fan-beam densitometers are now available that can image the thoracic and lumbar spines and detect deformities consistent with fracture. We report a pilot study of 342 patients referred for bone densitometry who had lateral vertebral imaging performed. Fifty patients (14.6%) of the entire cohort had one or more vertebral deformities identified on lateral vertebral imaging. Seventy-three patients (21.3%) of the entire cohort were 60 or more years of age and had osteopenia by World Health Organization (WHO) criteria (T-score: -1.0 to -2.4 at the spine, total hip, or femoral neck). Twenty of these patients (27.4%) had one or more vertebral deformities. Without identifying prevalent vertebral deformities, these individuals at high risk for fracture may not be offered pharmacologic therapy to reduce fracture risk. Therefore, it may be reasonable to obtain lateral vertebral imaging at least for individuals age > or =60 yr who have mild to moderate bone loss at the spine or hip.