Advantages & Benefits
Using the same quantitative measurements that are used in clinical trials
Vertebral deformities can be difficult to distinguish from normal anatomical variations in vertebral shape. The standard assessment for vertebral deformity in clinical trials involves measurement of either vertebral body heights or semi-quantitative scoring assessments.
Classifications of deformity are most often defined by height ratios, comparing the anterior, posterior, and mid vertebral heights from lateral lumbar and thoracic vertebral x-rays. Evaluation is complicated by the influence of ageing and certain diseases which can make vertebral margins difficult to define.
In clinical trials, SpineAnalyzerTM may be used to automatically detect vertebral body shapes from the lateral x-rays. From these contours, vertebral heights can be determined, and vertebral shapes can be compared to “normal” anatomy to determine if degenerative changes or disease may be influencing the measurement.
Comprehensive lateral spine reporting
The importance of documenting vertebral fracture for making treatment decisions in osteoporosis is well-understood and promoted by the International Osteoporosis Foundation (IOF) & European Society of Musculoskeletal Radiology (ESSR) in a set of educational tools, the Vertebral Fracture Initiative (VFI). The VFI is a web-tutorial designed to encourage radiologists and clinicians to report vertebral fractures using SQ and quantitative methods on radiographs and DXA scans, to report them clearly as “fractures” and recommend appropriate investigation and management.
Detecting non-clinical vertebral fractures to prevent secondary fracture
Postmenopausal women with vertebral fractures represent an important target for secondary vertebral and non-vertebral fracture prevention, but few of these patients come to clinical attention. Recent evidence suggests that screening postmenopausal women for clinical risk factors like height loss and fracture risk identifies those at high risk of prevalent vertebral fractures who should be referred for diagnostic x-rays. The National Osteoporosis Guidelines Group in the UK state that patients with a vertebral fracture should be considered for treatment without the need for further risk assessment.
Standardised reporting
The assessment of vertebral deformity needs to be standardised as there are unacceptably high false-positive and false-negative rates reported in academic studies. The most common causes of false-negatives are under-reporting of “incidental” deformities and the use of ill-defined terminology such as “slight wedging”.
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