Parkinsonism & related disorders · 2025
Upper-thoracic predominance and non-vertebral fracture burden in Parkinson's disease: A matched Case-Control study.
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Kang Min Soo, Jung Yoon Tae, Kim Seonok, Kim Won
Аннотация
INTRODUCTION: We investigated whether Parkinson's disease (PD) alters the topographical distribution of vertebral fractures and the burden of concomitant non-vertebral fractures in patients with osteoporotic vertebral fractures (OVFs).
METHODS: Among 1627 OVF patients, 116 with PD were matched (up to 1:4) to 349 controls by age, sex, and duration of radiographic surveillance. Group differences were analyzed using generalized linear mixed models, adjusting for femoral neck bone mineral density (BMD).
RESULTS: PD Patients exhibited higher adjusted risks of total (risk ratio [RR] 2.35, p < 0.001) and vertebral fractures (RR 1.46, p < 0.001). Upper-thoracic (T1-T10) fracture counts were nearly threefold higher in PD (RR 2.97, p < 0.001), with increased prevalence (odds ratio [OR] 1.90, p = 0.010). Although the adjusted within-person proportion of upper-thoracic fractures was not significant (p = 0.125), level-specific mapping showed increased prevalence across T4-T10 in patients with PD. Non-vertebral fractures were markedly more common in PD, particularly at the hip (OR 11.71), distal radius/ulna (OR 20.98), and ribs (OR 8.44) (all p < 0.001). Femoral neck T-scores were significantly lower in PD (p = 0.009).
CONCLUSION: In patients with prevalent OVFs, PD is associated with a higher fracture burden and a distinct upper-thoracic pattern, even after adjustment for femoral neck BMD. The frequent concomitant non-vertebral fractures underscore fall-related biomechanical risks, highlighting the need for osteoporosis management that includes thoracic imaging and PD-specific interventions.
METHODS: Among 1627 OVF patients, 116 with PD were matched (up to 1:4) to 349 controls by age, sex, and duration of radiographic surveillance. Group differences were analyzed using generalized linear mixed models, adjusting for femoral neck bone mineral density (BMD).
RESULTS: PD Patients exhibited higher adjusted risks of total (risk ratio [RR] 2.35, p < 0.001) and vertebral fractures (RR 1.46, p < 0.001). Upper-thoracic (T1-T10) fracture counts were nearly threefold higher in PD (RR 2.97, p < 0.001), with increased prevalence (odds ratio [OR] 1.90, p = 0.010). Although the adjusted within-person proportion of upper-thoracic fractures was not significant (p = 0.125), level-specific mapping showed increased prevalence across T4-T10 in patients with PD. Non-vertebral fractures were markedly more common in PD, particularly at the hip (OR 11.71), distal radius/ulna (OR 20.98), and ribs (OR 8.44) (all p < 0.001). Femoral neck T-scores were significantly lower in PD (p = 0.009).
CONCLUSION: In patients with prevalent OVFs, PD is associated with a higher fracture burden and a distinct upper-thoracic pattern, even after adjustment for femoral neck BMD. The frequent concomitant non-vertebral fractures underscore fall-related biomechanical risks, highlighting the need for osteoporosis management that includes thoracic imaging and PD-specific interventions.