Historical height loss can help predict the likelihood of vertebral fractures and the subsequent need for spine radiographs, according to a new formula outlined in Osteoporosis International.¹

Researchers analyzed 323 postmenopausal women between the ages of 50 and 92. Using a state-of-the-art wall-mounted stadiometer, the researchers found that the likelihood of vertebral fractures predictably rises as the height loss of the patient increases. Specifically, if patients are 6 cm shorter than their tallest recalled height, there is a 60% chance that their height loss is due to vertebral fracture and, therefore, a spine radiograph is warranted.

Prospective height loss can also indicate vertebral fractures, the study suggests. If a patient loses 2 cm or more over a period of 1 to 3 years, there is a greater than 40% chance that a vertebral fracture is the cause of the height loss, and a spine radiograph should be prescribed.

"A lot of guidelines say ‘measure height,' but they don't say what numbers should be used to trigger anything," explains lead study author Kerry Siminoski, MD, associate professor of radiology and medicine and an endocrinologist at the University of Alberta in Edmonton, Canada. "It's kind of out there in some guidelines, but people don't know how to use it, so this study gives solid numbers."

Numbers can be adjusted based on needs

The numbers highlighted in the study are absolute, Dr. Siminoski tells CIAOMed. For instance, "if you want to pick up everyone with a fracture, you have to set the height loss threshold lower. You can potentially alter the cutoff depending on whether you want to pick up more or less fractures." With the 6 cm historical height loss figure, "we will only get 30% of fractures," he says.

The new findings will also likely be valid outside of the research arena, says Dr. Siminoski. For example, "if someone comes in for a bone density screen, we [measure with the stadiometer], and if they meet the threshold, we do the x-ray." Moreover, doctors can use either stadiometers or common measuring devices. "It looks like it works just as well in the general population as it does in the research setting, and it almost doesn't matter what you use to measure height, which means that people can do it at home," he tells CIAOMed.

Reference

1. Siminoski K, Warshawski RS, Jen H, et al. The accuracy of historical height loss for the detection of vertebral fractures in postmenopausal women. Osteoporos Int. 2006;17:290-296.