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Vertebral Body Reshaping after Fractures: An Important Index of Recovery in Glucocorticoid-Treated Children.
Ma, Jinhui; Siminoski, Kerry; Jaremko, Jacob L; Koujok, Khaldoun; Matzinger, Mary Ann; Shenouda, Nazih; Wilson, Nagwa; Cheng, Megan; Alos, Nathalie; Atkinson, Stephanie; Cummings, Elizabeth A; Ho, Josephine; Rodd, Celia; Sbrocchi, Anne Marie; Stein, Robert; Barr, Ronald; Cairney, Elizabeth; Dix, David B; Fernandez, Conrad V; Grant, Ronald; Halton, Jacqueline; Israels, Sara; Laverdière, Caroline; Lewis, Victor A; Cabral, David A; Huber, Adam; Houghton, Kristin; Jurencak, Roman; Lang, Bianca; Larché, Maggie; LeBlanc, Claire M A; Miettunen, Paivi; Roth, Johannes; Scuccimarri, Rosie; Bell, Lorraine; Blydt-Hansen, Tom; Filler, Guido; Feber, Janusz; Phan, Véronique; Smit, Kevin; Rauch, Frank; Ward, Leanne M.
Affiliation
  • Ma J; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
  • Siminoski K; Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB T6G 2B7, Canada.
  • Jaremko JL; Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB T6G 2B7, Canada.
  • Koujok K; Department of Radiology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Matzinger MA; Department of Radiology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Shenouda N; Department of Radiology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Wilson N; Department of Radiology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Cheng M; Faculty of Health Sciences, McMaster University, Hamilton, ON L8N 3Z5, Canada.
  • Alos N; Département de pédiatrie, Université de Montréal, Montréal, QC H3T 1C5, Canada.
  • Atkinson S; Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada.
  • Cummings EA; Department of Pediatrics, Dalhousie University/IWK Health, Halifax, NS B3K 6R8, Canada.
  • Ho J; Department of Pediatrics, University of Calgary, Calgary, AB T3B 6A8, Canada.
  • Rodd C; Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
  • Sbrocchi AM; Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada.
  • Stein R; Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5W9, Canada.
  • Barr R; Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada.
  • Cairney E; Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5W9, Canada.
  • Dix DB; Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada.
  • Fernandez CV; Department of Pediatrics, Dalhousie University/IWK Health, Halifax, NS B3K 6R8, Canada.
  • Grant R; Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada.
  • Halton J; Department of Pediatrics, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Israels S; Department of Pediatrics and Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
  • Laverdière C; Département de pédiatrie, Université de Montréal, Montréal, QC H3T 1C5, Canada.
  • Lewis VA; Department of Pediatrics, University of Calgary, Calgary, AB T3B 6A8, Canada.
  • Cabral DA; Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada.
  • Huber A; Department of Pediatrics, Dalhousie University/IWK Health, Halifax, NS B3K 6R8, Canada.
  • Houghton K; Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada.
  • Jurencak R; Department of Pediatrics, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Lang B; Department of Pediatrics, Dalhousie University/IWK Health, Halifax, NS B3K 6R8, Canada.
  • Larché M; Department of Medicine, McMaster University, Hamilton, ON L8S 4K1, Canada.
  • LeBlanc CMA; Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada.
  • Miettunen P; Department of Pediatrics, University of Calgary, Calgary, AB T3B 6A8, Canada.
  • Roth J; Department of Pediatrics, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Scuccimarri R; Department of Pediatrics, Kantonsspital Luzern, 6004 Luzern, Switzerland.
  • Bell L; Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada.
  • Blydt-Hansen T; Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada.
  • Filler G; Department of Pediatrics, University of British Columbia, Vancouver, BC V6H 3V4, Canada.
  • Feber J; Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5W9, Canada.
  • Phan V; Department of Pediatrics, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Smit K; Département de pédiatrie, Université de Montréal, Montréal, QC H3T 1C5, Canada.
  • Rauch F; Department of Pediatrics, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada.
  • Ward LM; Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3G 2M1, Canada.
J Clin Endocrinol Metab ; 109(3): e1225-e1237, 2024 Feb 20.
Article in En | MEDLINE | ID: mdl-37843393
PURPOSE: In this 6-year study we identified factors associated with spontaneous vertebral body reshaping in glucocorticoid (GC)-treated children with leukemia, rheumatic disorders, and nephrotic syndrome. METHODS: Subjects were 79 children (mean age 7.4 years) who had vertebral fracture (VF) evaluation on lateral spine radiographs at least 1 year after VF detection. VF were graded using the modified Genant semiquantitative method and fracture burden for individuals was quantified using the spinal deformity index (SDI; sum of grades from T4 to L4). RESULTS: Sixty-five children (82.3%) underwent complete vertebral body reshaping (median time from VF detection to complete reshaping 1.3 years by Cox proportional hazard modeling). Of 237 VF, the majority (83.1%) ultimately reshaped, with 87.2% reshaping in the thoracic region vs 70.7% in the lumbar region (P = .004). Cox models showed that (1) every g/m2 increase in GC exposure in the first year after VF detection was associated with a 19% decline in the probability of reshaping; (2) each unit increase in the SDI at the time of VF detection was associated with a 19% decline in the probability of reshaping [hazard ratio (HR) = 0.81; 95% confidence interval (CI) = 0.71, 0.92; P = .001]; (3) each additional VF present at the time of VF detection reduced reshaping by 25% (HR = 0.75; 95% CI = 0.62, 0.90; P = .002); and (4) each higher grade of VF severity decreased reshaping by 65% (HR = 0.35; 95% CI = 0.21, 0.57; P < .001). CONCLUSION: After experiencing a VF, children with higher GC exposure, higher SDI, more severe fractures, or lumbar VF were at increased risk for persistent vertebral deformity.
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Full text: 1 Database: MEDLINE Main subject: Spinal Fractures / Fractures, Bone / Osteoporotic Fractures Limits: Child / Humans Language: En Year: 2024 Type: Article
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Full text: 1 Database: MEDLINE Main subject: Spinal Fractures / Fractures, Bone / Osteoporotic Fractures Limits: Child / Humans Language: En Year: 2024 Type: Article