Anatomical distribution of vertebral fractures: comparison of pediatric and adult spines


Authors: Siminoski K, Lee KC, Jen H, Warshawski R, Matzinger MA, Shenouda N, Charron M, Coblentz C, Dubois J, Kloiber R, Nadel H, O'Brien K, Reed M, Sparrow K, Webber C, Lentle B, Ward LM; STOPP Consortium.

Source: Osteoporos Int. 2011 Nov 23.


Siminoski et al. from University of Alberta, Edmonton, Canada reports that the anatomical distribution of vertebral fractures differs between children and adults, probably relating to the different shape of the immature spine.

The authors compared the distribution of vertebral fractures in adults and children and found that fractures occurred in different locations in the two age groups.

The authors compared the distribution of VF defined using the Genant semi-quantitative method (GSQ method).

The authors found that: "The average age in the adult cohort was 62.9 years (standard deviation (SD), 13.4 years), 26% was male, the mean lumbar spine Z-score was -1.0 (SD, 1.5), and the corresponding T-score was -2.4 (SD, 1.4). The pediatric cohort median age was 7.7 years (range, 2.1-16.6 years), the mean lumbar spine Z-score was -1.7 (SD, 1.5), 52% was male, and disease categories were acute lymphoblastic leukemia (66%), rheumatological conditions (21%), and nephrotic syndrome (14%). The VF distribution was biphasic in both populations, but the peaks differed in location. In adults, the peaks were at T7/T8 and at T12/L1. In children, the focus was higher in the thoracic spine, at T6/T7, and lower in the lumbar spine, at L1/L2. When children were assessed in two age-defined sub-groups, a biphasic VF distribution was seen in both, but the upward shift of the thoracic focus to T6 was observed only in the older group, with the highest rates of fracture present between ages 7 and 10 years".

According to these results, the authors concluded that the anatomical distribution of VF differs between children and adults, probably relating to the different shape of the immature spine, notably the changing ratio of kyphosis to lordosis.


Link for the abstract:http://www.ncbi.nlm.nih.gov/pubmed/22109742


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