Bone Abstracts

Sacral insufficiency fracture is known as a common cause of lumbosacral pain developed without evident trauma in patients with osteoporotic spinal compression fracture. The purpose of study was to investigate the incidence and predisposing factors of sacral insufficiency fracture accompanied by osteoporotic spinal compression fracture.

We carried out a retrospective study of 949 patients who were measured bone mineral densitometry (BMD) and showed osteoporotic spinal compression fracture on MRI between January 2008 and December 2012. Sacral insufficiency fracture was diagnosed by MRI and whole body bone scan. We analyzed the correlations between sacral insufficiency fracture and demographic, clinical factors such as sex, age, BMI, BMD, comorbidities (hypertension, diabetes, rheumatoid arthritis, and thyroid disease), the number of osteoporotic spinal compression fracture.

Among 949 patients with osteoporotic spinal compression fracture (80 (8%) males and 869 (92%) females), 40 (4.2%) had sacral insufficiency fractures (7 (17.5%) males and 33 (82.5%) females). There were significantly differences in age, the number of compression fracture and the osteoporosis severity between the groups. Mean age was significantly different between the patient groups with or without sacral insufficiency fracture (71.0 vs 65.6 years; P<0.05). The mean number of osteoporotic spinal compression fracture was significantly different between the patient groups with or without sacral insufficiency fracture (2.75 vs 1.87; P<0.05). The severity of osteoporosis was significantly different between the patient groups with or without sacral insufficiency fracture(−3.05 vs −2.19; P<0.05).

Sacral insufficiency fracture should be assessed carefully in patients with lumbosacral pain. High index of suspicion is needed for old age, multilevel osteoporotic spinal compression fractures, and severe osteoporosis.