Prediction of new clinical vertebral fractures in elderly men using finite element analysis of CT scans

  • Wang X
  • Sanyal A
  • Cawthon P
 et al. 
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Vertebral strength, as estimated by finite element analysis of computed tomography (CT) scans, has not yet been compared against areal bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA) for prospectively assessing the risk of new clinical vertebral fractures. To do so, we conducted a case-cohort analysis of 306 men aged 65 years and older, which included 63 men who developed new clinically-identified vertebral fractures and 243 men who did not, all observed over an average of 6.5 years. Nonlinear finite element analysis was performed on the baseline CT scans, blinded to fracture status, to estimate L1 vertebral compressive strength and a load-to-strength ratio. Volumetric BMD by quantitative CT and areal BMD by DXA were also evaluated. We found that, for the risk of new clinical vertebral fracture, the age-adjusted hazard ratio per standard deviation change for areal BMD (3.2; 95% confidence interval [CI], 2.0-5.2) was significantly lower (p

Author-supplied keywords

  • aged
  • article
  • bone density
  • bone strength
  • computer assisted tomography
  • dual energy X ray absorptiometry
  • finite element analysis
  • geriatric patient
  • human
  • lumbar spine
  • major clinical study
  • male
  • risk
  • risk assessment
  • sensitivity and specificity
  • spine fracture

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  • X Wang

  • A Sanyal

  • P M Cawthon

  • L Palermo

  • M Jekir

  • J Christensen

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