Prevalent vertebral deformities: relationship to bone mineral density and spinal osteophytosis in elderly men and women
- PMID: 8783298
- DOI: 10.1007/BF01622740
Prevalent vertebral deformities: relationship to bone mineral density and spinal osteophytosis in elderly men and women
Abstract
The aims of this study were to ascertain vertebral deformity prevalence in elderly men and women and to describe the association between bone mineral density (BMD) at the lumbar spine and femoral neck, severity of spinal degenerative disease and vertebral deformity prevalence. We performed standardized spinal radiographs in a random sample of 300 elderly men and women participating in the Dubbo Osteoporosis Epidemiology Study, a population-based study of fracture risk factors. Radiographs were read independently by masked observers for the prevalence of vertebral deformity and severity of osteophytosis. BMD was measured by dual-energy X-ray absorptiometry. The prevalence of vertebral deformities was critically dependent on the criterion used. The less strict criteria seemed to overestimate deformities at either end of the spine region analysed. However, irrespective of the criterion used, prevalence of deformity was higher in men than in women (25% vs 20% for the 3 SD criterion, 17% vs 12% for the 4 SD criterion and 27% vs 25% for the 25% criterion). Femoral neck BMD was more strongly associated with vertebral deformities than spinal BMD for the 25% criterion (OR/SD change in BMD 1.39 (p = 0.02) vs 1.20 (p = 0.19)), 3 SD criterion (OR/SD change in BMD 1.45 (p = 0.01) vs 1.10 (p = 0.34)) and 4 SD criterion (OR/SD change in BMD 1.98 (p = 0.0002) vs 1.68 (p = 0.008)). BMD was also more strongly associated with biconcave deformities than either wedge or crush deformities and more so in men than in women. Severity of spinal osteophytosis was not associated with vertebral deformity. In conclusion, femoral neck BMD is at least equivalent to the lumbar spine BMD in strength of association with prevalent vertebral fractures. Spinal osteophytosis falsely elevates BMD without a concomitant decrease in fracture risk, indicating that any interpretation of spinal BMD needs to be adjusted for osteophytosis. These findings support the use of femoral neck bone densitometry in older men and women. Moreover, these data indicate that current criteria for radiological assessment of vertebral deformity are sufficiently loose to include a substantial proportion of non-fractures in the elderly, with important implications for the design of clinical trials. However, irrespective of the criterion used, vertebral deformities in men are at least as common, if not more so, than in women, suggesting that vertebral osteoporotic fractures are overlooked in men.
Similar articles
-
[Vertebral deformity as an index of osteoporosis-induced spinal fracture--an external validity construct based on bone density data].Med Klin (Munich). 1998 Mar 15;93 Suppl 2:46-55. doi: 10.1007/BF03041999. Med Klin (Munich). 1998. PMID: 9564158 German.
-
Sex difference in the validity of vertebral deformities as an index of prevalent vertebral osteoporotic fractures: a population survey of older men and women.Osteoporos Int. 2000;11(2):102-19. doi: 10.1007/PL00004172. Osteoporos Int. 2000. PMID: 10793868
-
Vertebral deformity in men.J Bone Miner Res. 1992 Nov;7(11):1259-65. doi: 10.1002/jbmr.5650071120. J Bone Miner Res. 1992. PMID: 1466252
-
Diagnostic value of ultrasound analysis and bone densitometry as predictors of vertebral deformity in postmenopausal women.Osteoporos Int. 1995;5(6):413-8. doi: 10.1007/BF01626601. Osteoporos Int. 1995. PMID: 8695961 Review.
-
Bone densitometry and vertebral fracture assessment.Curr Osteoporos Rep. 2010 Sep;8(3):123-30. doi: 10.1007/s11914-010-0018-z. Curr Osteoporos Rep. 2010. PMID: 20556673 Review.
Cited by
-
Progression of vertebral deformity of prevalent vertebral fractures in the elderly: a population-based study.BMC Musculoskelet Disord. 2024 Feb 5;25(1):110. doi: 10.1186/s12891-024-07254-y. BMC Musculoskelet Disord. 2024. PMID: 38317112 Free PMC article.
-
Optimizing percutaneous vertebroplasty: extra-facet puncture for osteoporotic vertebral compression fractures.J Orthop Surg Res. 2023 Nov 22;18(1):887. doi: 10.1186/s13018-023-04368-2. J Orthop Surg Res. 2023. PMID: 37993875 Free PMC article.
-
Osteoporotic vertebral compression fracture accompanied with thoracolumbar fascial injury: risk factors and the association with residual pain after percutaneous vertebroplasty.BMC Musculoskelet Disord. 2022 Apr 11;23(1):343. doi: 10.1186/s12891-022-05308-7. BMC Musculoskelet Disord. 2022. PMID: 35410277 Free PMC article.
-
The association between incident vertebral deformities, health-related quality of life and functional impairment: a 10.7-year cohort study.Osteoporos Int. 2021 Nov;32(11):2247-2255. doi: 10.1007/s00198-021-06004-3. Epub 2021 May 19. Osteoporos Int. 2021. PMID: 34009448
-
The influence of long-term shoulder loading on sagittal spino-pelvic morphology: a population-based retrospective study of Chinese farmers from radiology.J Orthop Surg Res. 2020 May 29;15(1):196. doi: 10.1186/s13018-020-01698-3. J Orthop Surg Res. 2020. PMID: 32471454 Free PMC article.
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical