Severity of vertebral fractures is associated with alterations of cortical architecture in postmenopausal women.

Patients with vertebral fractures (VFx) have trabecular architectural disruption on iliac biopsies. Because cortical bone is an important determinant of bone strength, we assessed cortical and trabecular microarchitecture at peripheral sites in patients with VFx of varying number (N) and severity (S). Bone architecture and volumetric density (vBMD) were assessed at the distal radius and tibia with HR-pQCT (XTreme CT; Scanco Medical, Bassersdorf, Switzerland) in 100 women with VFx (age, 74 +/- 9 yr) of different S (GI, n = 23; GII, n = 35 ; GIII, n = 42) and in 362 women (age, 69 +/- 7 yr) without peripheral or VFx (G0) from the OFELY study.