Do Patients Older Than 60 Years With Inflammatory Bowel Disease Have More Vertebral Fractures Than Age-matched Controls? A Study Using Abdominal and Pelvic CT Scans With Sagittal Reformatting as Screening Tool.
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Date
2020
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Abstract
Introduction: Inflammatory bowel disease (IBD) has been associated with metabolic bone disease and increased fractures. This association is directly influenced by the disease and indirectly influenced by treatment. Therefore, patients with IBD could develop an elevated risk of osteoporotic fractures, particularly vertebral compression fractures (VCFs); however, symptomatic VCFs have not been shown to be more common in these patients. Our study evaluated the prevalence of VCF, independent of the presence of spinal symptoms, in IBD patients.
Methods: We assessed IBD patients previously enrolled in a prospective cohort. All patients from that cohort who underwent computed tomography (CT) scans for nonspinal conditions were evaluated to detect the presence of VCFs. VCFs were classified using the Genant scheme. We evaluated whether patients with or without VCF differed in demographic data, type of IBD, treatment received and time from diagnosis. We used logistic regression to assess the independent effect of each variable.
Results: In total, 6.5% of these patients had at least one VCF. Most fractures were Genant I (77%) and mostly at the thoracolumbar junction (T11 to L2, 65%). Bivariate and logistic regression analyses showed that age was the only variable independently associated with VCF (OR 1.12, 1.05 to 1.19).
Conclusion: VCFs are not unusual in OBD patients. Radiologists and clinicians should specifically look for the presence of VCFs in patients with IBD, particularly the elderly, by using abdominal and pelvic CT scans.
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Vertebral compression fractures, Inflammatory bowel disease, Computed tomography scans, Sagittal reformations, Spinal fractures