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A4.7 Prevalence of vertebral fractures, after 50 years old
  1. K Nassar,
  2. S Janani,
  3. W Rachidi,
  4. O Mkinsi
  1. Department of Rheumatology, University Hospital Ibn Rushd, Casablanca

Abstract

Introduction Fragility fractures are number growing. They reduced quality life and increased mortality. After 50 years, one woman and two men will have an osteoporotic fracture in their lifetime. The presence of a vertebral fracture (VF) multiplied by 4-5, the risk of new vertebral fracture occurrence, and by 3 the risk of hip fracture. They are pauci or asymptomatic.

Study purpose Evaluate the prevalence of fragility vertebral fractures after 50 years, the number of asymptomatic fractures, and eventually other forms of spinal disease which may constitute a differential diagnosis.

Materials and Methods Prospective study conducted at the rheumatology department at the Hospital University of Ibn Rochd in Casablanca. The study included 51 patients ≥ 50 years old. Stady was done between December 2012 and March 2013. Patients made thoracolumbar spine radiograph X-Rays requested among the 73 cases. Last history factors, personal or family bone fragility were research. After physical examination, analysis of radiographs was based on the semi-quantitative method of Genant, specifying the grade, the seat and the number of FV. They were correlated with clinical and laboratory data. The prevalence of FV was calculate,and the percentage of asymptomatic fractures.

Results Our population was predominantly female (86.2%). The mean age was 61 years. 66.6% of patients had back pain. 19 cases had at least one VF. Among them, six were asymptomatic. In the FV group, 6 patients had a personal history of bone fragility factors. 2 cases had a history of non-traumatic fracture and one case among parents. One patient was treated and cured for breast neoplasis. The majorities of patients were in vitamin D or already supplemented. 5 cases treated for osteoporosis, 10 patients were under anti-osteoporotic, 4 unknown osteoporotic. 11 cases followed for osteoarthritis. 3 cases had the notion of loss in size between 2 and 5 cm. 13 had a fracture grade I, 4 grade II and two grade III. 10 patients had a single fracture, 8 two fractures, and only one patient, 3 fractures. All fractures were lumbar seat and attributed to osteoporosis. Treatment was symptomatic and by orthopedic immobilization. Regarding the group without VF, in the subgroup without back pain, one case had a degenerative spinal deformity and 10 had no spine abnormality. As for the subgroup with back pain, 10 had spinal scoliosis, 4 cases had a degenerative spine, and 8 normal spine.

Discussion and Conclusion The clinical signs of vertebral fractures are not specific. Their severity is variable. They pose problem of differential diagnosis of vertebral deformities or neoplastic. View prognosis, research vertebral fractures after 50 years is essential.

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