Equivalent values between anterior vertebral height, wedge ratio, and wedge angle in osteoporotic vertebral fractures.

INTRODUCTION: Vertebral mobility (V-mobility) has been used to diagnose fresh osteoporotic vertebral fractures (OVFs), and determine or predict bone union by setting cutoff values for these purposes. V-mobility is defined as the difference in shape of vertebral bodies between lateral radiographs taken in weight-bearing and non-weight-bearing positions. The parameters for V-mobility have varied in previous reports among anterior vertebral height (Ha, mm), wedge ratio (WR, %), and wedge angle (WA, degrees). The present study aimed to clarify WR and WA equivalent to Ha of 1.0 mm, and to compare the reported cutoff values for V-mobility presented as Ha, WR, or WA. MATERIALS AND METHODS: Lateral radiographs of 446 normal vertebrae (grade 0) and 146 deformed vertebrae (grade 1-3) from T11 to L2 were obtained from 183 female patients aged > 60 years. WR (%) values equivalent to Ha of 1.0 mm were calculated by Ha (1.0 mm)/Hp × 100 (Hp: posterior vertebral height). Corresponding WA values were calculated by trigonometric function using vertebral dimensions. RESULTS: The mean WR values equivalent to Ha of 1.0 mm in the vertebrae from T11 to L2 were 3.2%, 3.2%, 3.5%, and 3.7% for grades 0, 1, 2, and 3, respectively, and the corresponding WA values were 1.6°, 1.6°, 1.5°, and 1.4°. CONCLUSION: The equivalent values for V-mobility presented as Ha, WR, and WA were obtained. The mean WR and WA values equivalent to Ha of 1.0 mm in grade 1-3 vertebrae were 3.5% and 1.5°, respectively.

Equivalent values between anterior vertebral height, wedge ratio, and wedge angle for evaluating vertebral mobility and deformity in osteoporotic vertebral fractures: a conventional observational study.

BACKGROUND: Vertebral mobility (V-mobility) has been used to diagnose fresh osteoporotic vertebral fractures (OVFs) and determine bone union by setting cutoff values for these purposes. V-mobility is the difference in vertebral height on dynamic radiographs taken in the sitting and lateral decubitus or supine positions. The dimensions for V-mobility were presented as anterior vertebral height (Ha; mm), wedge ratio (WR; %), and wedge angle (WA; °) in previous reports. This study was performed to obtain WR and WA values equivalent to V-mobility of 1.0 mm in Ha. METHODS: Lateral radiographs of 284 OVFs (grade 1-3 deformed vertebrae) from T11 to L2 were obtained from 77 patients with OVF. V-mobility presented as Ha, posterior vertebral height, and WA was obtained by the difference in these dimensions on dynamic radiographs. The WR and WA values equivalent to 1.0 mm in Ha were obtained by dividing the V-mobility values for WR and WA by that for Ha. RESULTS: The mean WR values corresponding to 1.0 mm in Ha for grade 1, 2, and 3 vertebrae were 3.2% ± 1.4%, 3.2% ± 0.9%, and 3.4% ± 1.0%, respectively, and the corresponding value for grade 1-3 vertebrae was 3.3% ± 1.0%. The mean WA values corresponding to 1.0 mm in Ha for grade 1, 2, and 3 vertebrae were 1.5° ± 0.8°, 1.5° ± 0.6°, and 1.5° ± 0.8°, respectively, and the corresponding value for grade 1-3 vertebrae was 1.5° ± 0.7°. CONCLUSIONS: The WR and WA values equivalent to V-mobility of 1.0 mm in Ha were 3.3% and 1.5°, respectively, in grade 1-3 vertebrae. These findings may be useful to secure a reliable value of V-mobility of OVFs using simultaneous measurements in three dimensions (Ha, WR, and WA) in clinical practice and to establish cutoff values for V-mobility to determine bone union.

Fear of Falling and Cognitive Impairments in Elderly People with Hip Fractures.

BACKGROUND/AIM: The purpose of this study was to investigate the estimated prevalence of dementia and the relationship between cognitive impairment and fear of falling in patients with hip fractures. METHODS: Analysis 1 included 100 patients with hip fractures. Analysis 2 included a subgroup of subjects with ≥75 years of functional independence: 46 patients with hip fractures and 46 control subjects without hip fractures, and presence or absence of dementia. We used an informant-rated questionnaire including the AD8 for screening for dementia, the Barthel Index for assessing activities of daily living, and the Short Falls Efficacy Scale-International (FES-I) for assessing fear of falling. RESULTS: The estimated prevalence of dementia was 66% in patients with hip fractures. There were significant fracture and dementia effects, with significant covariate effects of age and gender on the Short FES-I scores. CONCLUSION: Our results suggested that more than two-thirds of patients with hip fractures had dementia. Fear of falling may reflect not only physical functions but also cognitive impairments.