Sacral Insufficiency Fracture with Osteoporotic Compression Fracture of the Thoracolumbar Spine : Incidence and High Risk Factors

ABSTRACT

OBJECTIVE: The sacral insufficiency fractures (SIFs) are not uncommon and usually occur in osteoporotic bone with minimal or unremembered trauma. Especially, if they are accompanied by osteoporotic compression fracture of the thoracolumbar spine, SIFs can be usually overlooked due to subtle clinical symptoms and signs coupled with radiographic findings. The review aims to be raising awareness of the incidence & risk factors of the SIFs. METHODS: We retrospectively reviewed the 252 patients who were admitted at our hospital due to osteoporotic compression fracture of the thoracolumbar spine with minimal or unremembered trauma for 5 years. We assessed the incidence of the SIF being accompanied by osteoporotic compression fracture of the thoracolumbar spine and the effects according to sex, age, probable risk factors (diabetes mellitus & arterial hypertension), the location of fracture and the severity of osteoporosis. RESULTS: 252 patients, including 36 men (14.3%) and 216 women (85.7%) were involved in this study and the osteoporotic compression fractures were located at thoracic (36 cases), thoracolumbar junction (180 cases), lumbar spine (36 cases). There are 18 cases (the incidence 7.1%), including 2 men (5.5%) and 16 women (7.4%) in which the SIF was accompanied by osteoporotic compression fracture of the thoracolumbar spine. The effects according to sex, age, probable risk factors, the location of fracture and the severity of osteoporosis were not statistically different in both groups (group with SIF and group without SIF). CONCLUSION:The clinicians need to consider the possibility of SIF in patients of osteoporotic compression fracture of the thoracolumbar spine.