title: Low clinical relevance of a prevalent vertebral fracture in elderly men--the MrOs Sweden study.
abstract: BACKGROUND
  The epidemiology, the fracture pattern, and the clinical relevance of prevalent vertebral fractures in old men are debated wherefore we set out to clarify these issues.
  
  
  METHODS
  Mister Osteoporosis (MrOs) Sweden is a population-based cohort of community-living men aged 69-81 years that includes 3,014 men. Out of these, 1,453 men underwent a lateral radiograph of the thoracic and lumbar spine of which 1,427 were readable and classified by a radiologist, that is the sample size in this study. The men also answered a questionnaire evaluating back pain and limitation in activities of daily living (ADLs) because of back pain during the preceding 12 months in addition with fracture history and life style.
  
  
  RESULTS
  Fifteen percentage of the men had at least one prevalent vertebral fracture, but only 1/10th of these were aware of their fracture. Among the men with a fracture, 58% had one, 21% two, 9% three, and 11% four or more fractures. In men with only one fracture, 70% of the fractures were located in the thoracic and 30% in the lumbar spine, 85% had a wedge, 13% a biconcave, and 2% a crush-type configuration; one-quarter had a maximum vertebral body compression degree of less than 24% and one-quarter of more than 38%. Among the men with one or several vertebral fracture, 57% reported back pain compared with 55% in those without a fracture (p=.53). Most ADL functions were similar in the men with or without a prevalent vertebral fracture. In the men with one fracture, there was no difference in the occurrence of back pain depending on the fractured region (p=.49), type of the fracture (p=.77), or degree of compression (p=.85). In men with one or several fractures, there were no significant differences in the presence of back pain in any ages (p=.08), nor there were differences in presence of back pain regarding type (p=.08) or number of fractures (p=.21).
  
  
  CONCLUSIONS
  A prevalent vertebral fracture is common in old men but has low clinical relevance. There does not seem to be a specific fracture pattern that predisposes for back pain.
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Stortorget 9, 211 22 Malmo, Sweden. Electronic address: mehrsa.kherad@med.lu.se.
authors.forename: Mehrsa
authors.initials: M
authors.lastname: Kherad
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Stortorget 9, 211 22 Malmo, Sweden.
authors.forename: Björn E
authors.initials: BE
authors.lastname: Rosengren
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Stortorget 9, 211 22 Malmo, Sweden.
authors.forename: Ralph
authors.initials: R
authors.lastname: Hasserius
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Stortorget 9, 211 22 Malmo, Sweden.
authors.forename: Jan-Åke
authors.initials: JÅ
authors.lastname: Nilsson
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Stortorget 9, 211 22 Malmo, Sweden.
authors.forename: Inga
authors.initials: I
authors.lastname: Redlund-Johnell
authors.affiliation: Center for Bone and Arthritis Research, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Sahlgrenska I.C., Box 7163, SE-402 33 Göteborg, Sweden.
authors.forename: Claes
authors.initials: C
authors.lastname: Ohlsson
authors.affiliation: Geriatric Medicine, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Sahlgrenska I.C., Box 7163, SE-402 33 Göteborg, Sweden.
authors.forename: Mattias
authors.initials: M
authors.lastname: Lorentzon
authors.affiliation: Geriatric Medicine, Institute of Medicine, Gothenburg University, Sahlgrenska University Hospital, Sahlgrenska I.C., Box 7163, SE-402 33 Göteborg, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Mellström
authors.affiliation: Clinical and Molecular Osteoporosis Research Unit, Departments of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Stortorget 9, 211 22 Malmo, Sweden.
authors.forename: Magnus K
authors.initials: MK
authors.lastname: Karlsson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D058866:Osteoporotic Fractures / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011859:Radiography; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: Back pain; MrOSstudy; Old men; Population-based cross-sectional study; Vertebrae; Vertebral fracture