Sacral insufficiency fracture with compression fracture of the thoracolumbar spine : Analysis of coincidence rate and risk factors

ObjectivesThe purpose of present study was to investigate the coincidence rate and risk factors of sacral insufficiency fracture accompanied by compression fracture of thoracolumbar spine.Material and methodsThe candidates for this study were 945 patients who measured their bone mineral density (BMD) and showed spinal compression fracture on MRI or CT between January 2008 and December 2012. Sacral insufficiency fracture was diagnosed by MRI and the whole body bone scan. We assessed the risk factors of sacral insufficiency fracture which include sex, age, body mass index (BMI), underlying diseases (hypertension, diabetes mellitus, rheumatoid arthritis, and thyroid disease), the number of spinal compression fractures and the presence of osteoporosis.ResultsAmong 945 patients with spinal compression fracture [76 (8%) males and 869 (92%) females], 36 (3.8%) had sacral insufficiency fractures (3 [8.3%] males and 33 [91.7%] females). Age and the presence of osteoporosis among risk factors were significant (p < 0.05). Logistic regression analysis indicated that age(odds ratio: 3.7, p = 0.019) and the presence of osteoporosis(odds ratio: 5.4, p < 0.0001) were associated with the coincidence rate of sacral insufficiency fracture.ConclusionsThe coincidence rate of sacral insufficiency fracture is about 3.8%. The clinicians should evaluate sacral insufficiency fractures more actively in patient with compression fracture of thoracolumbar spine accompanied by risk factors (age, the presence of osteoporosis).