MedWire News: Spine radiographs improve the identification of patients who might benefit from osteoporosis treatment for spinal deformity among elderly women at risk for the disease, Dutch research suggests.

“In this population of elderly women with clinical risk factors for osteoporosis and bone mineral density (BMD) T-score ≥-2.5, both at the spine and the hips, addition of spine radiographs in the overall risk assessment identified a substantial number of women at high risk who can benefit from therapeutic interventions,” report JC Netelenbos (VU University Medical Center, Amsterdam) and co-workers.

“Spine radiographs, which are relatively cheap and readily available world-wide, should therefore be considered in these women and, in case of vertebral fractures, anti-osteoporotic treatment should be considered.”

The team examined the prevalence of osteoporosis in 631 women aged 60 years or older with two or more risk factors for osteoporosis, such as early menopause or low weight, finding that 30% of the women had osteoporosis (T-score <--2.5) at the hip or spine.

Of the remaining 444 women with BMD levels above the diagnostic threshold who agreed to undergo spine radiographs, one or more vertebral deformities were detected in 21%.

The researchers note that of the patients who completed the case-finding strategy, 47% were eligible for osteoporosis therapy.

“Assessment of vertebral fracture status, in addition to BMD, provides practical and relevant clinical information to aid in predicting fracture risk in postmenopausal women and in the selection of treatment,” Netelenbos et al conclude.

“Since prevalent fractures in non-osteoporotic women have a very high predictive value for future fractures, it can safely be assumed that treatment of women with risk factors and prevalent vertebral fractures but non-osteoporotic BMD-scores will be highly cost effective.”

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