Vertebral Compression Fractures: Towards a Standard Scoring Methodology in Paleopathology

Abstract Vertebral compression fractures are the most common osteoporotic fractures in postmenopausal women. Notwithstanding, its clinical diagnosis remains ambiguous. In paleopathological studies, vertebral fractures and/or deformations are frequently disregarded. When observed, vertebral compression fractures are usually recorded without the support of quantifiable and comparable protocols. As such, Genant's semi‐quantitative method for vertebral compression fracture assessment was applied to a large sample ( N = 196) from the Coimbra Identified Skeletal Collection, Portugal, and the reliability of the method was tested. Vertebral fracture scoring agreement was evaluated with the kappa statistic and the per cent of agreement. Intra‐observer agreement was almost perfect, whereas inter‐observer agreement was substantial to almost perfect. The Genant's semi‐quantitative scoring methodology is easy to apply and highly reproducible; as such, it should be adopted as the standard method to score vertebral fractures in any paleopathological investigation. Copyright © 2014 John Wiley & Sons, Ltd.