Objective: Bone involvement in patients with β-thalassemia is well known, but only few studies have analyzed bone microarchitecture and the prevalence of intervertebral disc calcifications (IDCs) in these patients. Objective of our study was to evaluate the vertebral bone involvement in a group of patients with β-thalassemia in terms of geometry and bone quality; moreover, we evaluated the presence and site of IDCs in these patients. Material and Methods: Our retrospective case–control study was conducted in adults with β-thalassemia (aged 18– 50 years). Patients were divided, according with the ISCD criteria, into 2 groups: subjects with BMD Zs≤−2.0, below the expected range for age, and subjects with BMD Zs> −2.0, within the expected range for age. Assessment of bone quality was performed using the Trabecular Bone Score (TBS), stratifying subjects into 3 groups: with degraded (TBS ≤1.200), partially degraded (TBS >1.200 and <1.350), and normal (TBS ≥1.350) trabecular microarchitecture. Finally, we evaluated the presence of IDCs highlighted by images of vertebral fracture assessment. Results: We evaluated 49 patients with β-thalassemia, mean aged 35.2± 9.6 years, divided into two groups: 25 patients with Zs≤−2.0 and 24 patients with Zs> −2.0. There was a statistically significant difference between groups in number of fragility fractures (p = 0.0339). Furthermore, TBS of patients with Zs≤−2.0 was significantly lower than individuals with Zs >−2.0 as mean value (p= 0.0006) and as categorized value (p= 0.0061). Finally, we evidenced in 7 patients (14.29 %) the presence of at least one IDC. Conclusions: Our results showed that β-thalassemia is characterized not only by a reduction in BMD, but also by a bone geometry and bone microarchitecture involvement, highlighting that TBS should be included in the assessment of these subjects, in order to obtain a proper diagnosis, management and prevention of fragility fractures; furthermore, presence of IDCs should be better investigated.

P151 VERTEBRAL BONE QUALITY AND INTERVERTEBRAL DISC ALTERATIONS IN PATIENTS WITH BETA-THALASSEMIA: A RETROSPECTIVE STUDY

Moretti A;F. Gimigliano;G. Iolascon
2016

Abstract

Objective: Bone involvement in patients with β-thalassemia is well known, but only few studies have analyzed bone microarchitecture and the prevalence of intervertebral disc calcifications (IDCs) in these patients. Objective of our study was to evaluate the vertebral bone involvement in a group of patients with β-thalassemia in terms of geometry and bone quality; moreover, we evaluated the presence and site of IDCs in these patients. Material and Methods: Our retrospective case–control study was conducted in adults with β-thalassemia (aged 18– 50 years). Patients were divided, according with the ISCD criteria, into 2 groups: subjects with BMD Zs≤−2.0, below the expected range for age, and subjects with BMD Zs> −2.0, within the expected range for age. Assessment of bone quality was performed using the Trabecular Bone Score (TBS), stratifying subjects into 3 groups: with degraded (TBS ≤1.200), partially degraded (TBS >1.200 and <1.350), and normal (TBS ≥1.350) trabecular microarchitecture. Finally, we evaluated the presence of IDCs highlighted by images of vertebral fracture assessment. Results: We evaluated 49 patients with β-thalassemia, mean aged 35.2± 9.6 years, divided into two groups: 25 patients with Zs≤−2.0 and 24 patients with Zs> −2.0. There was a statistically significant difference between groups in number of fragility fractures (p = 0.0339). Furthermore, TBS of patients with Zs≤−2.0 was significantly lower than individuals with Zs >−2.0 as mean value (p= 0.0006) and as categorized value (p= 0.0061). Finally, we evidenced in 7 patients (14.29 %) the presence of at least one IDC. Conclusions: Our results showed that β-thalassemia is characterized not only by a reduction in BMD, but also by a bone geometry and bone microarchitecture involvement, highlighting that TBS should be included in the assessment of these subjects, in order to obtain a proper diagnosis, management and prevention of fragility fractures; furthermore, presence of IDCs should be better investigated.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11591/419781
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