Spatial relationships between prevalent and incident spine fractures

Women with prevalent fractures have an increased risk of developing additio nal, incident fractures. This article examines the relation between the loc ation of prevalent fractures within the spine and the risk of subsequent ve rtebral fractures. The subjects were 721 Japanese-American women of mean ag e 69.5 +/- 5.3 (SD) years. For the analyses, the spine was categorized into three regions: an upper region, vertebrae T3-11; a middle region, vertebra e T-12 and L-1; and a lower region, vertebrae L2-5. Initial analyses were l imited to women with, at most, one prevalent fracture, Compared to women wi thout fracture, women with a prevalent fracture had odds ratios of 2-5 for developing an incident fracture outside the prevalent region. Subsequent an alyses included women with multiple prevalent fractures. Women having two o r three prevalent fractures had odds ratios of 7-9 for developing an incide nt fracture outside the prevalent region. The results suggest that the incr eased fracture risk of women with prevalent fractures extends beyond nearby vertebrae, and can affect vertebrae both above and below the prevalent fra cture. (Bone 24:261-264; 1999) (C) 1999 by Elsevier Science Inc. All rights reserved.