Vertebral fractures are the hallmark manifestation of osteoporosis, associated with back pain, increased morbidity and functional limitations. Prevalent vertebral fractures are associated with increased risk of hip fractures, and increased risk of mortality. Anti-osteoporotic treatments are effective in decreasing the risk of subsequent fractures in post-menopausal women with prevalent vertebral fractures. Thus, diagnosis of these fractures, even asymptomatic, is a key issue. Performing systematic X-ray is not feasible for radiation and costs concerns. Vertebral Fracture Assessment (VFA) is a new technology, through dual energy X-ray absorptiometry (DXA) devices. It delivers thus a low dose radiation and is considered now as a clinically useful alternative to standard spine X-rays. Cross sectional and prospective studies have shown good performance of VFA compared to X-rays for both prevalent and incident vertebral deformities. The main limitation of the technique is lack of visualisation of the upper thoracic spine (above T6) in some patients. VFA can be recommended when the results may influence clinical management, as concomitant glucocorticoid therapy. VFA is a reliable technique, which improves management of patients with primary or secondary osteoporosis.
Disclosure of Interest None declared
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