Vertebral Fractures: Which Radiological Criteria Are Better Associated With the Clinical Course of Osteoporosis?

Brian C. Lentle, Claudie Berger, Jacques P. Brown, Linda Probyn, Lisa Langsetmo, Ian Hammond, Jeff Hu, William D. Leslie, Jerilynn C. Prior, David A. Hanley, Jonathan D. Adachi, Robert G. Josse, Angela M. Cheung, Stephanie M. Kaiser, Tanveer Towheed, Christopher S. Kovacs, Andy Kin On Wong, David Goltzman

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Study Purpose: Morphometric methods categorize potential osteoporotic vertebral fractures (OVF) on the basis of loss of vertebral height. A particular example is the widely used semiquantitative morphometric tool proposed by Genant (GSQ). A newer morphologic algorithm-based qualitative (mABQ) tool focuses on vertebral end-plate damage in recognizing OVF. We used data from both sexes in the Canadian Multicentre Osteoporosis Study (CaMos) to compare the 2 methods in identifying OVF at baseline and during 10 years of follow-up. Materials and Methods: We obtained lateral thoracic and lumbar spinal radiographs (T4-L4) 3 times, at 5-year intervals, in 828 participants of the population-based CaMos. Logistic regressions were used to study the association of 10-year changes in bone mineral density (BMD) with incident fractures. Results: At baseline, 161 participants had grade 1 and 32 had grade 2 GSQ OVF; over the next 10 years, only 9 of these participants had sustained incident GSQ OVF. Contrastingly, 21 participants at baseline had grade 1 and 48 grade 2 mABQ events; over the next 10 years, 79 subjects experienced incident grade 1 or grade 2 mABQ events. Thus, incident grades 1 and 2 morphologic fractures were 8 times more common than morphometric deformities alone. Each 10-year decrease of 0.01 g/cm2 in total hip BMD was associated with a 4.1% (95% CI: 0.7-7.3) higher odds of having an incident vertebral fracture. Conclusions: This analysis further suggests that morphometric deformities and morphologic fractures constitute distinct entities; morphologic fractures conform more closely to the expected epidemiology of OVF.

Original languageEnglish (US)
Pages (from-to)150-158
Number of pages9
JournalCanadian Association of Radiologists Journal
Issue number1
StatePublished - Aug 5 2020

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: CaMos has been partly supported by the Canadian Institute for Health Research, and Amgen Co. The funding sources played no role in the data collection, analysis, interpretation or publication of the results described here. The authors thank all of the CaMos participants who made this work possible.

Publisher Copyright:
© The Author(s) 2020.


  • bone mineral density
  • gender differences
  • morphologic fractures
  • morphometric deformities
  • osteoporosis
  • vertebral fractures


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