Changes in vertebral wedging rate between supine and standing position and its association with back pain: A prospective study in patients with osteoporotic vertebral compression fractures

Study Design. Prospective consecutive series. Objective. To analyze supine and standing radiographs and the association of back pain using subjective pain criteria. Summary of Background Data. It has been considered that there is little correlation between the degree of collapse of the vertebral body and the level of pain. In previous studies, however, measurements have only been based on supine radiographs. Although there were 2 authors who reported the results of supine lateral and standing lateral radiographs in patients with thoracolumbar vertebral fractures, as far as we know, there has not been any detailed report concerning the correlation between radiologic findings using supine and standing lateral radiographs and back pain. Methods. We examined 100 consecutively treated patients, prospectively. Back pain and the supine and standing radiographs were assessed 1 month after injury. Changes in vertebral wedging rate (WR) from supine to standing position (Delta WR) was reported by the following equation: Delta WR = WR(standing) - WR(supine). Results. The median age of the cohort was 75 years (range, 60 - 89 years). The median VAS of back pain at supine position, at standing position, and when standing erect was 13, 33, and 41, respectively. The median wedging rate on the supine and standing radiographs were 28% and 37%, respectively (P < 0.001). There was a significant correlation between = WR and back pain when standing erect (r = 0.79, P < 0.001). Conclusion. Changes in vertebral wedging rate between supine and standing position and its association with back pain may give a clue to the pathogenesis of