J Korean Soc Spine Surg.  2012 Dec;19(4):138-144. 10.4184/jkss.2012.19.4.138.

Survival Analysis of Conservative Treatement in Osteoporotic Vertebral Fracture

• Koh YD
• Kim JO
• Kim RG
• Kim DY
• Kim NK
• Kim DJ

• KMID: 2209548
• DOI: http://doi.org/10.4184/jkss.2012.19.4.138

Abstract

STUDY DESIGN: Prospective study.
OBJECTIVES
To define the prognostic factors by analyzing the survival rates of osteoporotic vertebral fracture treated by conservative management. SUMMARY OF THE LITERATURE REVIEW: Due to an increasing elder population, many recent studies of osteoporosis have been done; pointing out that osteoporotic vertebral fracture may produce serious complications. However, there is nothing obviously demonstrated in both the management and prognosis of the osteoporotic vertebral fracture.
MATERIALS AND METHODS
Survival analysis was done for 130 patients who had undergone conservative management for a single level vertebral fracture. Univariant and multivariant survival analysis was done for age at trauma, sex, body mass index (BMI), bone mineral density (BMD), smoking, diabetic history, fracture level, fracture type, vertebral compression ratio and regional Cobb's angle.
RESULTS
Survival rate for conservative management was 70.7%. Univariant analysis for survival rate revealed significantly inferior results for age over 78 (p=0.008), T score< -3.5 (p=0.047), and crush or biconcave type than wedge type (p=0.021). Only the age factor showed significance in multivariant analysis (p=0.025, Hazard ratio=2.08).
CONCLUSION
Conservative management in a single level osteoporotic vertebral fracture, showed a survival rate of 70.7% and age was the most important factor in conservative management. We should notice that age of more than 78 years is at high risk for failure in conservative management of vertebral fracture.

Keyword

Osteoporotic vertebral fracture; Conservative management; Survival analysis; Prognostic factor

MeSH Terms

Age Factors
Body Mass Index
Bone Density
Humans
Osteoporosis
Prognosis
Prospective Studies
Smoke
Smoking
Survival Analysis
Survival Rate
Smoke

Figure

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  Fig. 1. Measurement of vertebral compression ratio by the following formula, [(A+C)/2-B]/[(A+C)/2]. ∗A: anterior vertebral height of upper vertebra, B: anterior vertebral height of fracture level, C: anterior vertebral height of lower vertebra.

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  Fig. 2. Measurement of regional Cobb's angle on plain radiograph.

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  Fig. 3. The Survival rate was 91.5% at 2 weeks, 78.5% at 1month, 72.3% at 2months, and 70.7% at 3months.

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  Fig. 4. Univariate Analysis. (A) Age, (B) Fracture types, (C) Bone mineral density.

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