Bone Test Predicts Spine Fracture
Low Bone-Mineral Density Predicts Later Spine Fracture in Women
Dec. 18, 2007 -- Postmenopausal women who seem healthy but have low
bone-mineral density are at risk of spinal
fracture later in life.
The finding comes from a 15-year study of nearly 2,700 women who were an
average 69 years old at the start of the study.
Spinal fracture is the most common kind of fracture in women with
osteoporosis, notes study researcher Jane A. Cauley, DrPH, of the University of
Pittsburgh. It is also among the most feared consequences of aging, causing
limited daily activities, and reduced quality of life.
"The idea is to prevent these fractures in the first place," Cauley
tells WebMD. "People used to think osteoporosis was an inevitable part of
aging. It is not inevitable. If you have a risk factor for osteoporosis, have a
BMD test and talk to a doctor about your various treatment options."
Cauley's team also found that women who have a "silent,"
symptom-free spinal fracture are four times more likely to suffer a spinal
fracture than women with no fracture and normal bone-mineral density (BMD).
If women have both low BMD and a previous spinal fracture, they have a very
high risk of another spinal fracture. More than half of these women will have a
new fracture, Cauley says.
A woman's overall risk of spinal fracture isn't small. The study showed that
18% of 69-year-old women had a spinal fracture within 15 years. The effect of
doubling or quadrupling this risk is very large indeed.
"About a third of women with low BMD had a fracture, compared to only 9%
among women with normal BMD," Cauley says. "For women with a low BMD
and existing spinal fracture, about 56% had a new fracture. So clearly the two
things to focus on are BMD and whether a fracture exists."
Cauley advises women at higher risk of osteoporosis to have their BMD
checked before they reach their 60s.
"The current recommendation is all women 65 and older should have a BMD
test. We think we should go a step further for some women younger than
that," she says. "If you have a risk such as a mother who had a hip
fracture, you're a current smoker, or if you fell recently and broke your
wrist, then you should talk to a doctor and see about having a BMD
That sounds like sensible advice to Scott D. Boden, MD, professor of
orthopaedic surgery and director of the Emory University Spine Center in
"Many factors go into risk of spinal fracture -- not only BMD but bone
architecture, genetics, exercise level, hormonal status, lots of different
things," Boden tells WebMD. "But if you have risk factors, it does not
hurt to get your BMD screened. Because if your bone mass is low you should
preserve it before you lose it. Now with these new treatments for osteoporosis,
there are options worth considering for younger women."
Cauley and colleagues report their findings in the Dec. 19 issue of The
Journal of the American Medical Association.