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Background Anxiety in combination with osteoporotic vertebral compression fractures (OVCFs) of the spine remains understudied. The purpose of this study was to analyze whetheranxiety has an impact on the short-term functional outcome of patients with an OVCF. Furthermore, a direct impact of the fracture on the patient’s anxiety during hospitalization should be recognized. Methods A prospective multicentric study in a German-speaking area was performed. All inpatients with an OVCF of the thoracolumbar spine from 2017 to 2020 were included. Trauma mechanism, analgetic medication, anti-osteoporotic therapy, timed-up-and-go test (TuG), mobility, Barthel index, Oswestry-Disability Index (ODI) and EQ5D-5L were documented. For statistical analysis, the U test, chi-square independence test, Spearman correlation, General Linear Model for repeated measures, Bonferroni analysis and Wilcoxon test were used. The item anxiety/depression of the EQ5D-5L was analyzed to describe the patients’ anxiousness. Results Data from 518 patients from 17 different hospitals were evaluated. Fracture severity showed a significant correlation (r=0.087, p=0.0496) with anxiety. During the hospital stay, pain medication (pConclusions Higher anxiety is associated with lower functional outcome after OVCF. The item anxiety/depression of the EQ5D-5L provides an easily accessible, quick and simple tool that can be used to screen for poor outcomes and may also offer the opportunity for a specific anxiety intervention.

PurposeThe aim of this study was to evaluate the reliability of Hounsfield units (HU) for bone density measurement in spinal trauma. HU have already been demonstrated to be reliable for this purpose in degenerative spine disease.Methods This study is a retrospective cross-sectional analysis considering CT scanner model, slice thickness and HU in native and contrast CT scans. Linear regression, bivariate correlation and ROC analyses were performed to analyze the relationship between qCT values and HU. The inter-rater reliability of HU measurements was assessed using the intra-class correlation coefficient.Results344 patient datasets were analyzed. CT scanner model and slice thickness were found to have no significant impact on HU. The inter-rater reliability for HU measurements from native CT scans was ICC(3, 1)=0.932 (CI95: 0.919 – 0.943, pwithout CM+5 can be used to predict qCT values from native CT scan HU. ROC analysis revealed maximum sensitivity and specificity of 0.91 and 0.93, respectively, with a cut-off value of 93 HU to predict osteoporosis.For contrast CT scans we determined an ICC(3,1) of 0.889 (CI95: 0.801 – 0.948, pwith CM-4. The maximum sensitivity and specificity calculated using HU in the presence of contrast medium were 0.83 and 0.89 with cut-off of values of 122 and 125 HU, respectively, depending on the observer.ConclusionsHU are reliable for measurement of bone quality in spinal trauma, especially in native CT scans. HU measurements from contrast CT scans should be used more cautiously for bone quality estimation.