Vertebral fracture assessment

Abstract

Purpose of reviewThe technology and clinical applications of vertebral fracture assessment by dual-energy X-ray absorptiometry are assessed. Recent findingsVertebral fracture is the most common type of fragility fracture, yet most vertebral fractures are not clinically apparent. It is now recognized that they are associated with increased risk of future fracture, increased morbidity, and increased mortality. Vertebral fracture assessment is a method for imaging the spine by dual-energy X-ray absorptiometry to diagnose vertebral fractures. Vertebral fracture assessment exposes the patient to less radiation than conventional spine radiographs, with lower cost and greater convenience. Knowledge of vertebral fractures may change diagnostic classification, estimation of future fracture risk, and clinical management. Patients with prevalent vertebral fractures may benefit from pharmacological therapy that might not be given based only on bone mineral density and other clinical risk factors for fracture. Vertebral fracture assessment requires a compatible dual-energy X-ray absorptiometry system with vertebral fracture assessment software installed. Technologists performing vertebral fracture assessment must be trained in proper patient positioning and image analysis. The interpretation of vertebral fracture assessment is a skill that is acquired through training and experience. SummaryVertebral fracture assessment is a technology for diagnosing vertebral fractures that enhances estimation of fracture risk and helps to identify patients who are likely to benefit from pharmacological therapy.