Association between thoracolumbar kyphosis and fracture risk assessment tool in Korean postmenopausal women: A retrospective study
5 affiliations
- 1Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
- 2Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- 3Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- 4Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- 5Department of Nuclear Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
Abstract
Thoracolumbar kyphosis (TLK) has been suggested as a potential risk factor for vertebral fractures in postmenopausal women; however, its association with bone mineral density (BMD), trabecular bone score (TBS), and fracture risk assessment tools, such as the Fracture Risk Assessment Tool (FRAX), remain undefined. In this study, we investigated the association between the TLK level and fracture risk in postmenopausal women. We retrospectively analyzed the associations between the thoracolumbar Cobb (TLCobb) angle, baseline compression fractures, BMD, TBS, and volumetric BMD measured using dual-energy X-ray absorptiometry (DXA) and central quantitative computed tomography (cQCT). The study included 251 postmenopausal women (median age, 61 years; interquartile range, 56–69 years) who visited our hospital for health checkups between March 2020 and December 2021. Fracture risk was assessed using FRAX and TBS-adjusted FRAX. Baseline radiography revealed patients with compression fractures (n = 64, 25.498%), in whom the TLCobb angle was significantly higher. The TLCobb angle demonstrated a significant negative correlation with TBS. Baseline compression fractures and higher TLCobb angles were significant predictors of future fragility compression fractures, with a TLCobb angle > 9.4° established as the threshold value. DXA and FRAX had limitations in predicting future progressive or new-onset compression fractures. In conclusion, TLK was found to be associated with densitometric results, particularly TBS, and has predictive value for future compression fracture risk. Baseline compression fractures with higher TLCobb angles are potential predictors of fracture risk in postmenopausal women.
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BibTeX
@article{goh2026association,
title = {{Association between thoracolumbar kyphosis and fracture risk assessment tool in Korean postmenopausal women: A retrospective study}},
author = {Tae Sik Goh and Yun Kyung Jeon and Kyoungjune Pak and Jihyun Kim and Keunyoung Kim},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0358889},
url = {https://doi.org/10.1371/journal.pone.0358889},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association between thoracolumbar kyphosis and fracture risk assessment tool in Korean postmenopausal women: A retrospective study
AU - Tae Sik Goh
AU - Yun Kyung Jeon
AU - Kyoungjune Pak
AU - Jihyun Kim
AU - Keunyoung Kim
PY - 2026
DA - 2026/10/05
JO - PLOS One
DO - 10.1371/journal.pone.0358889
UR - https://doi.org/10.1371/journal.pone.0358889
AB - Thoracolumbar kyphosis (TLK) has been suggested as a potential risk factor for vertebral fractures in postmenopausal women; however, its association with bone mineral density (BMD), trabecular bone score (TBS), and fracture risk assessment tools, such as the Fracture Risk Assessment Tool (FRAX), remain undefined. In this study, we investigated the association between the TLK level and fracture risk in postmenopausal women. We retrospectively analyzed the associations between the thoracolumbar Cobb (TLCobb) angle, baseline compression fractures, BMD, TBS, and volumetric BMD measured using dual-energy X-ray absorptiometry (DXA) and central quantitative computed tomography (cQCT). The study included 251 postmenopausal women (median age, 61 years; interquartile range, 56–69 years) who visited our hospital for health checkups between March 2020 and December 2021. Fracture risk was assessed using FRAX and TBS-adjusted FRAX. Baseline radiography revealed patients with compression fractures (n = 64, 25.498%), in whom the TLCobb angle was significantly higher. The TLCobb angle demonstrated a significant negative correlation with TBS. Baseline compression fractures and higher TLCobb angles were significant predictors of future fragility compression fractures, with a TLCobb angle > 9.4° established as the threshold value. DXA and FRAX had limitations in predicting future progressive or new-onset compression fractures. In conclusion, TLK was found to be associated with densitometric results, particularly TBS, and has predictive value for future compression fracture risk. Baseline compression fractures with higher TLCobb angles are potential predictors of fracture risk in postmenopausal women.
SN - 1932-6203
ER -