title: Thoracolumbar kyphosis is associated with compressive vertebral fracture in postmenopausal women.
abstract: The main aim of this retrospective cross-sectional study was to examine the relationship between vertebral compression fracture and thoracolumbar Cobb angles. Fracture prevalence was found to be significantly higher for patients with moderate [odds ratio (OR) = 4.78 (2.88-7.95)] or severe kyphosis [OR = 10.7 (5.11-22.40)] than for patients with mild kyphosis. The relationship between degree of thoracolumbar kyphosis and vertebral compression fracture was analyzed.
  
  
  
  The hypothesis that vertebral compression fracture in women is related to thoracolumbar kyphosis severity was tested, and a clinically important cutoff degree of sagittal thoracolumbar Cobb angle (TLCobb) was determined.
  
  
  
  Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compiled for 212 postmenopausal women with thoracolumbar fracture (study group) and 150 postmenopausal women with degenerative lumbar disease (control group). Group proportions and characteristics were compared with chi-squared tests and unpaired t tests, respectively.
  
  
  
  In this retrospective cross-sectional study cohort, 17 patients had T11 fractures, 79 had T12 fractures, 89 had L1 fractures, and 27 had L2 fractures. QCT findings and TLCobb differed between the study and control groups (both p < 0.001). No significant differences were found in body mass index (BMI), disk height, or coronal TLCobb. After adjustment for age, BMI, and QCT findings, fracture prevalence was found to be higher in the thoracolumbar kyphosis study group than in the control group [OR = 6.16, 95% confidence interval (CI) 3.88-9.78]. Sagittal TLCobbs of 7.5-15° and >15° were associated with an increased fracture prevalence, with ORs of 4.78 (2.88-7.95) and 10.7 (5.11-22.40), respectively.
  
  
  
  Vertebral fracture prevalence in postmenopausal women was found to be associated with thoracolumbar kyphosis. A TLCobb sagittal angle >15° should be considered an indicator for vertebral fracture assessment.
authors.affiliation: Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, 100035, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, 100035, China. dr_weiyi@163.com.
authors.forename: W
authors.initials: W
authors.lastname: Tian
authors.affiliation: Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, 100035, China.
authors.forename: G L
authors.initials: GL
authors.lastname: Zhang
authors.affiliation: Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, 100035, China.
authors.forename: Y W
authors.initials: YW
authors.lastname: Lv
authors.affiliation: Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, 100035, China.
authors.forename: G Y
authors.initials: GY
authors.lastname: Cui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007738:Kyphosis / Q000150:complications* / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000000981:diagnostic imaging; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Osteoporosis; Postmenopausal women; Quantitative computed tomography; Thoracolumbar kyphosis; Vertebral fracture