historical height loss ≥ 4cm; self-reported, but undocumented prior vertebral fracture and glucocorticoid therapy equivalent to ≥5mg prednisolone for ≥ three months51
. In practice, adding VFA to a service and
scanning those at risk of vertebral fracture can improve targeting of treatment, with a modifiable underlying cause being found in 21% of those diagnosed with vertebral fracture26
. Since the presence of a prevalent
vertebral fracture is highly predictive of incident fractures, treatment decisions will be influenced by the identification of a vertebral fracture60-62
. However, VFA may not be required in patients with documented vertebral fractures unless a change in treatment decision depends on identification of an incident fracture62
Conclusion The use of VFA enhances DXA services, provides better identification of those who require treatment for fragility fractures and offers additional tools for cases where DXA struggles to achieve an accurate bone measurement. However, VFA is not indicated in all patients attending the service and should be targeted at those for whom epidemiological data demonstrate a heightened risk for vertebral fracture. In this group of patients, the additional costs and burden to the service are outweighed by the overwhelming benefits achieved by the diagnosis of a vertebral fracture. It is therefore an important addition for consideration in DXA services where it is not currently offered.
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One in twelve men and one in six women will suffer a symptomatic vertebral fracture during their lifetime
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