title: Changes in vertebral wedging rate between supine and standing position and its association with back pain: a prospective study in patients with osteoporotic vertebral compression fractures.
abstract: METHODS
  Prospective consecutive series.
  
  
  OBJECTIVE
  To analyze supine and standing radiographs and the association of back pain using subjective pain criteria.
  
  
  BACKGROUND
  It has been considered that there is little correlation between the degree of collapse of the vertebral body and the level of pain. In previous studies, however, measurements have only been based on supine radiographs. Although there were 2 authors who reported the results of supine lateral and standing lateral radiographs in patients with thoracolumbar vertebral fractures, as far as we know, there has not been any detailed report concerning the correlation between radiologic findings using supine and standing lateral radiographs and back pain.
  
  
  METHODS
  We examined 100 consecutively treated patients, prospectively. Back pain and the supine and standing radiographs were assessed 1 month after injury. Changes in vertebral wedging rate (WR) from supine to standing position (Delta WR) was reported by the following equation: Delta WR = WR(standing)-WR(supine).
  
  
  RESULTS
  The median age of the cohort was 75 years (range, 60-89 years). The median VAS of back pain at supine position, at standing position, and when standing erect was 13, 33, and 41, respectively. The median wedging rate on the supine and standing radiographs were 28% and 37%, respectively (P < 0.001). There was a significant correlation between Delta WR and back pain when standing erect (r = 0.79, P < 0.001).
  
  
  CONCLUSIONS
  Changes in vertebral wedging rate between supine and standing position and its association with back pain may give a clue to the pathogenesis of pain from osteoporotic thoracolumbar vertebral compression fractures.
authors.affiliation: Department of Orthopaedic Surgery, Teikyo University School of Medicine Ichihara Hospital, 3426-3 Anesaki, Ichihara-city, Chiba 299-0111, Japan. tomotomot2001@aol.com
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Wada
authors.forename: Koya
authors.initials: K
authors.lastname: Kamikawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Kenji
authors.initials: K
authors.lastname: Kimura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamasita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsushita
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Shiboi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kato
authors.forename: Ryutaku
authors.initials: R
authors.lastname: Kaneyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Otsuka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000175:diagnosis / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D050815:Fractures, Compression / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000503:physiopathology*; D010147:Pain Measurement; D011187:Posture / Q000502:physiology; D011446:Prospective Studies; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D016683:Supine Position / Q000502:physiology*; D013904:Thoracic Vertebrae / Q000502:physiology