Among older patients at risk for osteoporosis, hidden vertebral fractures substantially increase the risk of both hip fractures and additional vertebral fractures. Doctors from Pennsylvania’s Geisinger Health System have evaluated the VFA technique that allows fracture evaluation at the same time as a standard DXA bone density test - at a cost of just an additional $17 per test.
The cost to find a hidden vertebral fracture through this new technique is also approximately one-third of what it would have cost through existing DXA testing procedures. “DXA is a simple, safe, comfortable x-ray study that is the gold standard test for diagnosing osteoporosis and assessing future fracture risk. VFA is a new capability with certain DXA machines, that allows us to additionally assess whether someone has an existing vertebral fracture,” said Dr. Eric Newman, director of the Department of Rheumatology.
“This is important because three out of four spine fractures are asymptomatic - people don’t know that they have them, up to 30 percent of women over 50 may have a vertebral fracture, and the presence of a vertebral fracture that is not from trauma is a very strong predictor of future fracture at the spine, wrist, and hip, and by itself is enough to warrant treatment,” Newman explains.
Between October 2003 and February 2005, Geisinger researchers performed 2,155 VFAs during 3,745 DXA bone density exams. Vertebral fractures were found in 463 patients (21.5%) - with multiple vertebral fractures found in 172 patients (8.0%). Diagnosis of “risk changed to high” occurred in 153 patients (7.0%) - meaning that one out of 14 IVAs performed resulted in a significant change in risk diagnosis, and corresponding therapeutic recommendations.
“This study demonstrates that combining VFA with DXA provides essential diagnostic and therapeutic information at a nominal additional cost,” Newman summarises.
MEDICA.de; Source: Geisinger Medical Center