title: Anatomical distribution of vertebral fractures: comparison of pediatric and adult spines.
abstract: CONCLUSIONS
  We compared the distribution of vertebral fractures in adults and children and found that fractures occurred in different locations in the two age groups. This likely relates to the different shape of the immature spine.
  
  
  BACKGROUND
  We hypothesized that the anatomical distribution of vertebral fractures (VF) would be different in children compared to adults.
  
  
  METHODS
  We compared the distribution of VF defined using the Genant semi-quantitative method (GSQ method) in adults (N = 221; 545 fractures) and in children early in the course of glucocorticoid therapy (N = 44; 94 fractures).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  These results suggest that the anatomical distribution of VF differs between children and adults, perhaps relating to the different shape of the immature spine, notably the changing ratio of kyphosis to lordosis.
authors: Department of Radiology and Diagnostic Imaging, University of Alberta, 6628-123 Street, Edmonton, AB, Canada, T6H 3T6. kerrygs@telusplanet.net
authors: K
authors: K
authors: Siminoski
authors: K-C
authors: KC
authors: Lee
authors: H
authors: H
authors: Jen
authors: R
authors: R
authors: Warshawski
authors: M A
authors: MA
authors: Matzinger
authors: N
authors: N
authors: Shenouda
authors: M
authors: M
authors: Charron
authors: C
authors: C
authors: Coblentz
authors: J
authors: J
authors: Dubois
authors: R
authors: R
authors: Kloiber
authors: H
authors: H
authors: Nadel
authors: K
authors: K
authors: O'Brien
authors: M
authors: M
authors: Reed
authors: K
authors: K
authors: Sparrow
authors: C
authors: C
authors: Webber
authors: B
authors: B
authors: Lentle
authors: L M
authors: LM
authors: Ward
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007738:Kyphosis / Q000150:complications; D008141:Lordosis / Q000150:complications; D008159:Lumbar Vertebrae / Q000293:injuries; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000209:etiology; D058866:Osteoporotic Fractures / Q000139:chemically induced / Q000209:etiology / Q000473:pathology; D016103:Spinal Fractures / Q000209:etiology / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000293:injuries; D015599:Trauma Severity Indices
chemical_list: D005938:Glucocorticoids