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AB0856 T-score of the spine as predictor of the femoral neck fracture

Background Osteoporosis is defined as a progressive, systemic skeletal disorder characterized by low bone mass and micro-architectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fracture. There are numerous hip fracture risks. Bone mineral density (BMD) and T-score measured by dual-energy X-ray absorptiometry (DXA) are the main determinants of the clinical evaluation of hip fracture risk. World Health Organization classification defined osteoporosis as T-score below –2.5 SD. Objectives The aim of this study was to estimate differences in DXA measurements (BMD and T-score of the spine) and potential predictors of the femoral neck fracture in the patients with osteoporosis. Methods This study included 181 patients with osteoporosis (165 female and 16 male), average age of the 65, 6±8.5 years (range of 44.1 to 87.3 years). Eighty one patients had fracture of the femoral neck. All patients in this group were managed operatively by hip arthroplasty, after clinical and radiological diagnostic procedures. DXA measurement was performed on Advanced Prodigy Lunar device for these patients postoperatively. BMD of the femoral neck was measured on the no operated side. Age, sex, height, weight, BMI, BMD and T-score of the spine at the level of L1-L4, BMD of the right and left femoral neck were estimated. The control group included 100 patients with osteoporosis (93 female and 7 male), average age of the 65.1±8, 5 years. Student's t-test and Logistic regression were used for statistical analysis. Dependent variable was presence of the fracture of the femoral neck and independent variables were age, sex, height, weight, BMI, BMD and T-score of the spine and BMD of the femoral neck. Results Results of our study showed statistically significant difference between T-score of the spine (t=-2,973, p<0.01) as well as between BMD of the spine (t=-12,376, p<0.001) of patients with and without fracture of the femoral neck. T-score of the spine was significant predictor of fracture of the femoral neck (p<0, 01) when controlled by age, sex, height, weight, BMI, BMD of the spine, BMD of the femoral neck. Conclusions T-score and BMD of the spine were statistically significantly lower in patients with fracture of the femoral neck than in patients with osteoporosis without fracture. T-score of the lumbar spine was significant predictor of fracture of the femoral neck in patients with osteoporosis. Probability of femur neck fractures increased with the decrease of T-score of lumbar spine in patients with osteoporosis. These results can help in predicting femur neck fractures. References British National Formulary. September 2005; 385–9. Vid KS JA, Thien A, Hill R. Ann R. Implementation of and compliance with NICE guidelines in the secondary prevention of osteoporotic fractures in postmenopausal women. Coll Surg Engl 2008; 90: 213–5. Del Rio LM, et al. Is bone microarchitecture status of the lumbar spine assessed by TBS related to femoral neck fracture? A Spanish case-control study. Osteoporos Int. 2013; 24(3):991–8. Disclosure of Interest None declared