Verification of the semiquantitative assessment of vertebral deformity for subsequent osteoporotic fracture prediction and screening for the initiation of osteoporosis treatment: A case-control study using a clinical-based setting

BackgroundSemiquantitative grading of the vertebral body (SQ) is an easy screening method for vertebral body deformation. The validity of the SQ as a risk factor and as a screening tool for incident osteoporotic fractures (OF) was investigated using retrospective case-control data MethodsOutpatients followed up for [≥] two years as patients with osteoporosis were recruited. All of them were tested with X-ray images of the lateral thoracolumbar view and other tests at baseline. Patients were classified according to the SQ grade, and potential risk factors were compared for each SQ group. Cox regression analyses were conducted regarding the incident OFs separated into vertebral and non-vertebral fractures (VF and NVF). Statistical differences in the possible risk factors among the groups were examined, and the likelihood of the incident OFs in the variables was examined. After propensity score matching procedures of the confounding factors (PSM), the possibility of incident VFs was compared between the SQ grade groups. ResultsIn the crude dataset, the probabilities of incident VF in SQ Grade 3 and NVF in SQ Grade 1 or higher were significantly higher than in the other grades. Using a Cox regression analysis multivariant mode, the SQ grade was the only statistically significant factor for an incident VF, but not for NVF. However, no significant difference was shown after PSM for VFs. ConclusionsThese results suggested that the SQ classification was inappropriate for predicting an incident OFs. However, the grading showed significantly higher risk, therefore that is available for screening.