Vertebral Fractures Affect One-Third of Untreated Patients With OI Type I
Vertebral fractures were identified in 62 of 171 treatment-naïve participants (36%) with osteogenesis imperfecta (OI) type I in the Brittle Bone Disorders Longitudinal Study. The findings are scheduled for presentation at the American Society for Bone and Mineral Research (ASBMR) 2026 meeting, October 9–12.
The multicenter study included participants from the OI Linked Clinical Research Centers. Researchers assessed lateral spine radiographs for existing and new vertebral fractures using the Genant semi-quantitative method. They measured fracture burden with the Spinal Deformity Index (SDI), which sums Genant-defined fractures from T4 through L4.
Participants had a median age of 14.9 years, with ages ranging from 0.7 to 63.6 years; 36% were male. The researchers identified 157 vertebral fractures among the 62 affected participants. Fractures were present in 29 of 80 children (36%) and 38% of adults. Among the 157 fractures, 51 (32%) were moderate or severe.
Fractures were clustered in the mid-thoracic spine and thoracolumbar junction, and anterior wedge fractures predominated. Among participants with fractures, the median SDI was 2.0. Twenty-four of the 62 participants (39%) had an SDI of at least 4; all severe fractures occurred in this group.
During follow-up, 24 new vertebral fractures occurred in six participants after a median of 17 months. Among those with new fractures, the median SDI was 4.5. The abstract does not specify the follow-up denominator used to calculate the proportion of participants who developed a new fracture.
In age-stratified analyses, female sex and a lower body mass index z-score were associated with a higher SDI prevalence in children (P = .01 and P = .02, respectively). In adults, a lower height z-score was associated with a higher SDI prevalence (P = .006).
The authors interpreted the fractures observed across the age range—including in a child younger than 1 year—as support for timely identification through routine surveillance.
Reference
Halloun R, Santos R, Laffan E, et al. The vertebral fracture phenotype across the age spectrum in osteogenesis imperfecta type 1: results of the Brittle Bone Disorders Longitudinal Study. In: American Society for Bone and Mineral Research (ASBMR) 2026 Annual Meeting; October 9-12, 2026. Accessed October 7, 2026. https://eppro01.ativ.me/web/index.php?page=IntHtml&project=ASBMR26&id=p7721