It has long been recognized that a vertebral fracture is a strong predictor of future osteoporotic fractures and constitutes a diagnosis of osteoporosis. However, clear clinical guidelines on how to find vertebral fractures, only one third of which come to clinical attention, have been lacking. The National Osteoporosis Foundation’s newly revised Clinician’s Guide corrects this by making vertebral imaging equally important to the diagnosis of osteoporosis as bone densitometry.
In the section dedicated to vertebral imaging, the Guide states (page 21): “A vertebral fracture is consistent with a diagnosis of osteoporosis, even in the absence of a bone density diagnosis, and is an indication for pharmacologic treatment with osteoporosis medication to reduce fracture risk. Most vertebral fractures are asymptomatic when they first occur and often are undiagnosed for many years. Proactive vertebral imaging is the only way to diagnose these fractures.”
Most women over 65 and most men over 70* are recommended to be tested for vertebral fracture. Younger patients are indicated for vertebral imaging if they have suffered a low trauma fracture, have lost height, or have been on long-term glucocorticoid treatment.
“I am really gratified that the importance of vertebral fractures is finally captured in a guide with simple and actionable recommendations for clinicians on how to assess them”, said Felicia Cosman, MD, Osteoporosis specialist/endocrinologist at Helen Hayes Hospital in West Haverstraw, New York, Professor of Clinical Medicine at Columbia University, NY, NY and Chair of the NOF Guide Update Committee. “The new recommendations will bring more attention to the issue of vertebral fractures, encouraging physicians to perform screening imaging tests in appropriate patients. Finding a previously unrecognized vertebral fracture allows us to target medical therapy for osteoporosis to those who need it the most and could make a substantial impact on morbidity, disability and even death from further osteoporosis-related fracture events.”
“Optasia Medical’s SpineAnalyzer™ is a software workflow tool that helps document and report vertebral fractures quickly and comprehensively from both digital lateral spine x-ray images or VFA images generated on DXA scanners,” said Peter Steiger, CEO of Optasia Medical. “SpineAnalyzer’s clear and automated single page report communicates findings to referring physicians and patients in a concise but comprehensive manner, helping with clinical decision making.”
* All women over 70 and all men over 80. Women over 65 and men over 70 should be imaged if their BMD T-Score is -1.5 or below.