Objectifs. Preciser le retentissement d'une fracture vertebrale osteoporotique dont l'expression clinique datait de moins de trois mois sur les courbures rachidiennes. Methodes. Ces dernieres (cyphose dorsale et lordose lombaire) ont ete evaluees par un instrument applique sur le rachis, le curviscope. Ces parametres ont ete mesures a j0, j30, j90, j180, j365 et j1 095. Des radiographies de rachis dorsolombaire de face et de profil ont ete realisees a j365 et j1 095. Resultats. Soixante et une patientes souffrant d'osteoporose postmenopausique ont ete etudiees. Donnees transversales. Les fractures dorsales etaient a l'origine d'une augmentation significative de l'angle dorsal comparativement aux fractures dorsolombaires ou lombaires<space>: 64 o <space>+/-<space>9 contre 56 o <space>+/-<space>10 contre 56 o <space>+/-<space>13 (p<space><<space>0,05, respectivement). Aucune difference n'a ete constatee pour l'angle lombaire. Des correlations significatives ont ete mises en evidence entre l'angle dorsal et l'age (r<space>=<space>- 0,48, p <<space>0,001) ainsi que l'index de deformation vertebrale (r =<space>0,6, p <<space>0,001). Donnees longitudinales. Une augmentation significative de la cyphose dorsale a ete constatee des j90. Celle-ci etait de 5,6 o <space>+/-<space>0,7 a j1 095 (p <<space>0,01). La lordose lombaire a moderement augmente a j1 095 (p <<space>0,01). Cinq patients sur 13 avaient au moins une fracture vertebrale incidente a j365. Ce taux etait de 5/10 a j1 095. Bien qu'il n'ait pas ete constate de difference significative entre ces dernieres patientes et celles indemnes de fracture vertebrale incidente en termes de cyphose dorsale tant a j365 qu'a j1 095, cet angle etait en moyenne plus eleve chez les premieres comparativement aux secondes. Conclusion. Les fractures vertebrales dorsales sont a l'origine d'une augmentation significative de la cyphose dorsale comparativement aux fractures dorsolombaires ou lombaires. La cyphose dorsale s'accentue avec le temps chez les patientes ayant une fracture vertebrale prevalente. Ces donnees doivent nous amener a nous interroger sur l'apport de techniques susceptibles de corriger precocement les troubles statiques telles que la generalisation du port d'un corset ou la kyphoplastie.
Objectives. To evaluate spinal curvature changes over a three-year period in postmenopausal women who had had an osteoporotic vertebral fracture within the last three months. Methods: Thoracic kyphosis and lumbar lordosis were measured using a curviscope at baseline and after 1, 3, 6, 12, and 36 months. Anteroposterior and lateral radiographs of the thoracolumbar spine were obtained after 1 and 3 years. Results. Sixty-one patients were included. At baseline, a significant increase in thoracic curvature was found in the subgroup with thoracic fractures as compared to the subgroups with thoracolumbar or lumbar fractures (64 o +/-9 o , 56 o +/-10 o , and 56 o +/-13 o , respectively;<space> P<0.05). No lumbar curvature differences were found. Thoracic curvature was significantly correlated with age (r=-0.48, P<0.001) and with the vertebral deformity index (r=0.6, P<0.001). A significant increase in thoracic curvature was apparent 3 months into the study; after 3 years, the increase was 5.6 o +/-0.7 o (P<0.01). A moderate increase in lumbar curvature was found after 3 years (P<0.01). Five of 13 patients and 5 of 10 patients had at least one incident fracture after one and three years, respectively. Mean thoracic curvature was greater among the patients with than without incident fractures after one and three years, although the difference was not statistically significant. Conclusion. Thoracic compression fractures significantly increase thoracic kyphosis as compared to dorsolumbar and lumbar fractures. Thoracic kyphosis worsens over time in patients with prevalent vertebral fractures. These data invite an evaluation of techniques capable of providing early correction of alignment disorders, such as widespread use of bracing or kyphoplasty.