Introduction and objective:
Vertebral compression fractures (VCFs), which are a complication of osteoporosis, often cause diagnostic and therapeutic difficulties. The aim of this study was to find association between the characteristics of VCFs and the symptomatic status of patients.

Material and methods:
The study involved a total of 437 women with diagnosed postmenopausal osteoporosis (193 with at least one compression fracture and 244 without VCFs). To identify VCFs, all patients underwent morphometry using dual-energy X-ray absorptiometry. Based on the history of VCFs, subjects were divided into two groups: with symptomatic (n=59) and asymptomatic (n=134) VCFs.

Each patient had, on average, 2.03 ± 1.50 VCFs. Patients with VCFs were older [p<0.001] and shorter [p<0.001] than those without VCFs. VCFs located in the thoracic spine and the lumbar spine occurred with similar frequency (p=0.112). Multiple fractures in both spine segments (50.13%) were more frequent than fractures limited to only one section of the spine, either thoracic (22.76%) or lumbar (27.11%). The decreasing number of subjects was exponentially associated with the increasing number of VCFs (p<0.001). Symptomatic patients compared to asymptomatic patients had a higher serum concentration of 25-hydroxyvitamin D, and lower serum activity of alkaline phosphatase (p<0.01; p<0.005, respectively). In the lumbar spin, the risk of symptomatic VCFs was more than twofold higher compared to asymptomatic VCFs (p <0.001, OR=2.57, 95% CI: 1.57–4.19). Symptomatic status depended on the number of lumbar VCFs (p<0.001, OR=2.47, 95% CI: 1.68–3.63), as well as higher T-score L1-L4 (p=0.009, OR=1.43, 95% CI: 1.09–1.88).

Patients’ symptomatic status depends on the location and number of VCFs, as well as T-score L1-L4.

Ethical aspects. Research protocols were approved by the Ethics Committee of the Centre for Postgraduate Medical Education in Warsaw (No. 64/PB/2018). The study complied with the 1964 Declaration of Helsinki with its later amendments. All participants received detailed instructions regarding the protocols and written consent was obtained from all patients.
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