ESPEYB21 9. Oncology and Chronic Disease Bone Health and Chronic Diseases (2 abstracts)
9.16. Vertebral body reshaping after fractures: an important index of recovery in glucocorticoid-treated children
Ma J , Siminoski K , Jaremko JL , Koujok K , Matzinger MA , Shenouda N , Wilson N , Cheng M , Alos N , Atkinson S , Cummings EA , Ho J , Rodd C , Sbrocchi AM , Stein R , Barr R , Cairney E , Dix DB , Fernandez CV , Grant R , Halton J , Israels S , Laverdière C , Lewis VA , Cabral DA , Huber A , Houghton K , Jurencak R , Lang B , Larché M , LeBlanc CMA , Miettunen P , Roth J , Scuccimarri R , Bell L , Blydt-Hansen T , Filler G , Feber J , Phan V , Smit K , Rauch F & Ward LM
lward@cheo.on.ca J Clin Endocrinol Metab. 2024 Feb 20; 109(3):e1225-e1237. doi: 10.1210/clinem/dgad611. PMID: 37843393
Brief Summary: This prospective natural history study examined the timing and positive indicators for reshaping of vertebral fractures (VF) in glucocorticoid (GC)-treated patients with chronic diseases. Complete VF reshaping occurred in 82.3% of patients, with similar frequencies in all diagnosis groups (leukemia, rheumatic disorders and nephrotic syndrome) in a median time of 1.3 years. Likelihood of VF reshaping was positively related to higher lumbar spine bone mineral density (LS BMD) z-score, lower number of VF, lower cumulative GC exposure, lower spinal deformity index (SDI) and lower VF grade.
GC treatment is known to cause VF, that can persist over time and cause important sequelae in adult age, such as short stature, back pain and deformities. With its large sample-size and the annual radiographic assessment, this study provides essential information on the natural history of VF reshaping, identifying reshaping time and influencing factors. Reshaping is possible in children, even without treatment with bisphosphonate, as the paediatric skeleton is a highly dynamic structure.
Volume 21
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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