INTRODUCTION: Sitting lateral and supine position radiographs are useful to make a diagnosis of osteoporotic vertebral fracture and useful to evaluate intravertebral motion. The purpose of this study was to indicate correlation between fracture site instability and degrees of back pain using sitting lateral and supine position radiographs in conservatively treated osteoporotic vertebral fracture.
METHODS: Forty consecutive patients who were injured thoracolumbar osteoporotic vertebral fractures were followed for 12 weeks. There were 2 males and 38 females and 77 years old in average. Fracture site instability was measured by the difference of anterior/posterior vertebral body height ratio between sitting lateral and supine position radiographs (ΔA/P) as radiographic parameters. Weekly average of 100‐mm visual analog scale (VAS) was used as level of back pain. Radiographic parameters and VAS score were assessed within 2, 4, 8, 12weeks after injury. At 12 weeks after injury, the patients who complained back pain 30 mm or more were categorized into pain group (Group P). The other patients were classified into non‐pain group (Group N). The Mann‐Whitney U test was utilized to evaluated the differences of ΔA/P between both groups. The spearman correlation coefficient was used to test relationships between ΔA/P and degrees of VAS score.
RESULTS: The mean VAS score was 51, 40, 29, 25mm (at initial, 4, 8, and 12 weeks after injury). There were16 patients (40.0 %) in Group P and 24 (60.0 %) in Group N. There was not a significant correlation in ΔA/P between Group P and Group N (13.4 vs 9.9 at initial, 10.1 vs 10.4 at 4w, 7.1 vs 7.6 at 8w, 11.1 vs 10.3 at 12w). There was not a significant correlation betweenΔA/P and VAS score (r=0.232, p=0.16 at 4w, r=0.183, p=0.35 at 8w, r=0.106, p=0.67 at 12w).
DISCUSSION: In the current study, there was not a significant correlation between the degrees of fracture site instability and the degrees of back pain.