Prevalence and Characteristics of Morphometric Vertebral Fractures in the Spanish Population: Data from the OsteoSER Study

Carmen Gomez Vaquero¹, Montserrat Roig Kim², Jordi Fiter Areste³, Marta Domínguez-Álvaro⁴, Luis María Jiménez Liñán⁵, Miguel Bernad⁶, Antonio Álvarez-Cienfuegos⁷, Blanca Correa⁸, Antonio Pascual-Vergara⁹, Alejandra Montero Costa¹⁰, Cristina Momblan Trejo¹¹, Manuel Jiménez Rodríguez¹², María Anadón González¹³, Sara Josefina Barcat Zarate¹⁴, Sara Alvar Pariente¹⁵, Cristina Ruiz Pavón¹⁶, Pedro J. Lacalle Chanivet¹⁷, Balbina Marín de Prada¹⁸, Soledad García Frías¹⁹, Francisco Javier Maestro Saavedra²⁰, Marta Poch i Mora²¹, José Luis Gea González²², Carlota Quiroga Fernández²³, Eduardo Acevedo Martel²⁴ and Enrique González-Dávila²⁵, ¹Hospital Universitari de Bellvitge, ⁰⁸⁹⁰⁷ L'Hospitalet, Spain, ²Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain, ³Hospital Universitari Son Espases, Palma de Mallorca, Spain, ⁴Sociedad Española de Reumatología, Madrid, Spain, ⁵Hospital Don Benito-Villanueva, Don Benito, Spain, ⁶Hospital Universitario La Paz, Madrid, Spain, ⁷Hospital Vega Baja, Orihuela, Spain, ⁸Clínica Sanz y Correa, A Coruña, Spain, ⁹Centro de Salud Ronda-Norte y Ronda-Sur, Ronda, Spain, ¹⁰Centro de Salud Fuencarral, Madrid, Spain, ¹¹Centro de Atención Primaria Viladecans Montbaig, Sant Climent de Llobregat, Spain, ¹²Centro de Salud Don Benito Oeste, Don Benito, Spain, ¹³Consultorio de Pedrezuela, Pedrezuela, Spain, ¹⁴Centro de Salud Orihuela ¹-El Rabaloche, Orihuela, Spain, ¹⁵Centro de Salud Malpica, Malpica, Spain, ¹⁶Centro de Salud Ronda-Norte, Ronda, Spain, ¹⁷Centro de Salud de Santa Amalia, Santa Amalia, Spain, ¹⁸Centro de Atención Primaria Ramona Via i Pros, El Prat de Llobregat, Spain, ¹⁹Centro de Salud de Cortes de la Frontera, Cortes de la Frontera, Spain, ²⁰Centro de Salud Elviña Mesoiro, A Coruña, Spain, ²¹Centro de Atención Primaria CAP ¹⁷ de Setembre, El Prat de Llobregat, Spain, ²²Centro de Salud de Benejúzar, Benezujar, Spain, ²³Centro de Salud Os Mallos, A Coruña, Spain, ²⁴Centro de Salud Ronda-Sur Santa Bárbara, Ronda, Spain, ²⁵Departamento de Matemáticas. Universidad de La Laguna, Tenerife, Spain

Meeting: ACR Convergence 2025

Keywords: Bone density, Dual energy x-ray absorptiometry (DEXA), Fracture, Imaging, osteoporosis

Session Information

Date: Tuesday, October 28, 2025

Title: (2106–2123) Osteoporosis & Metabolic Bone Disease – Basic & Clinical Science Poster II

Session Type: Poster Session C

Session Time: 10:30AM-12:30PM

Background/Purpose: Most vertebral fractures (VFs) are asymptomatic. Vertebral Fracture Assessment (VFA) using DXA is a low-radiation method to detect morphometric vertebral fractures (MVFs). This study aimed to estimate MVF prevalence in Spanish adults aged ≥40 years and characterize affected individuals.

Methods: This population-based, cross-sectional study included individuals aged 40-80 years from 15 primary care centers across six Spanish provinces. VFA was performed with a mobile DXA unit (Hologic® Horizon W). Two rheumatologists independently evaluated vertebrae T10-L4 using Genant’s method (grade 1: 20-25% height loss; grade 2: 26-40%; grade 3: >40%), resolving discrepancies by consensus. Bone mineral density (BMD), clinical data, and fracture risk factors were recorded. After VFs were identified, primary care centers reviewed spine imaging and clinical records, and interviewed patients to classify fractures as fragility, traumatic, or morphometric.

Results: Among 1082 participants (50.3% male; mean age 60.4 years), MVFs were found in 171 (16%), totaling 244 fractures. MVFs were more frequent in men and associated with older age, prior fragility fractures, and osteoporosis. Proximal femur BMD was significantly lower in those with MVFs.Fracture severity was grade 1 in 63%, grade 2 in 31%, and grade 3 in 6%, with higher grades linked to older age and lower BMD. Most MVFs were wedge-shaped (type A, 80%), followed by biconcave (type M, 18%) and crush (type P, 2%). Type A was more frequent in men and younger individuals; types M/P were linked to osteoporosis and lumbar location. Most MVFs occurred at the thoracolumbar region (D12-L2).After review, 52 participants (4.8%) were classified as having clinical fragility VFs (CFVFs); 30 were undiagnosed, although 14 had prior radiographic evidence; 19 were traumatic and 100 morphometric VFs.CFVFs were mostly grade 2, type A, and thoracolumbar; traumatic VFs were mainly grade 1 and type A; morphometric VFs were predominantly grade 1, type A, with a dorsal-thoracolumbar distribution. Grade 3 and type P were rare but more common in CFVFs.CFVFs were more frequent in women and occurred at older age. They were associated with more prior non-vertebral fragility fractures, without significantly lower BMD or increased osteoporosis prevalence compared to other VF types.

Conclusion: In Spanish adults ≥40 years, MVFs were identified in nearly one-sixth of participants, more common in men and older individuals, and associated with lower BMD and prior fragility fractures. CFVFs represented an underdiagnosed subset, more prevalent among older women and associated with prior fragility fractures. Fracture characteristics differed by etiology.

Table 1. Sample characteristics according to the presence of MVFs on VFA and the underlying cause of the fracture.

Table 2. Variables related to bone metabolism according to the presence of vertebral fracture on VFA and the underlying cause of the fracture.

Disclosures: C. Gomez Vaquero: None; M. Roig Kim: None; J. Fiter Areste: None; M. Domínguez-Álvaro: None; L. Jiménez Liñán: None; M. Bernad: None; A. Álvarez-Cienfuegos: None; B. Correa: None; A. Pascual-Vergara: None; A. Montero Costa: None; C. Momblan Trejo: None; M. Jiménez Rodríguez: None; M. Anadón González: None; S. Barcat Zarate: None; S. Alvar Pariente: None; C. Ruiz Pavón: None; P. Lacalle Chanivet: None; B. Marín de Prada: None; S. García Frías: None; F. Maestro Saavedra: None; M. Poch i Mora: None; J. Gea González: None; C. Quiroga Fernández: None; E. Acevedo Martel: None; E. González-Dávila: None.

To cite this abstract in AMA style:

Gomez Vaquero C, Roig Kim M, Fiter Areste J, Domínguez-Álvaro M, Jiménez Liñán L, Bernad M, Álvarez-Cienfuegos A, Correa B, Pascual-Vergara A, Montero Costa A, Momblan Trejo C, Jiménez Rodríguez M, Anadón González M, Barcat Zarate S, Alvar Pariente S, Ruiz Pavón C, Lacalle Chanivet P, Marín de Prada B, García Frías S, Maestro Saavedra F, Poch i Mora M, Gea González J, Quiroga Fernández C, Acevedo Martel E, González-Dávila E. Prevalence and Characteristics of Morphometric Vertebral Fractures in the Spanish Population: Data from the OsteoSER Study [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/prevalence-and-characteristics-of-morphometric-vertebral-fractures-in-the-spanish-population-data-from-the-osteoser-study/. Accessed .

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