Abstract
Bone mineral density (BMD) was measured in the lumbar spine using dual-energy X-ray absorptiometry in 222 unscreened women (aged 50–82 years), and information on back pain and historic loss of standing height was obtained at interview. Vertebral morphometry was performed on lateral spinal radiographs. The shape of the vertebral body was quantified using appropriate vertebral shape indices (VSIs), and vertebral deformities were identified using thresholds defined in terms of the means (M) and standard deviations (SD) of these VSIs for the whole group. Severity of deformity was defined as either grade 1 (M+2SD<VSI<M+3SD), grade 2 (M+3SD<VSI<M+4SD or grade 3 (VSI>M+4SD). Subjects with grade 1 vertebral deformities were older than subjects without such deformities, but did not have a reduced age-related Z-score of BMD. Grade 2 wedge and concave deformities were associated with a reduced age-relatedZ-score of BMD, suggesting that the aetiology of such deformities is closest to conventional concepts of ‘osteoporotic fracture’. Grade 3 deformities were associated with neither increased age nor decreased BMD. Stature decreased in these subjects with age. Subjects reporting historic height loss had a higher mean number of wedge deformities. Subjects with back pain did not have a higher incidence of vertebral deformity than subjects without, confirming that many deformities were asymtomatic. Neither back pain nor historic loss of height were found to be associated with low spinal BMD.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aloia JF, Vaswani A, Atkins H, Zanzi I, Ellis K, Cohn SH. Radiographic morphometry and osteopenia in spinal osteoporosis. J Nucl Med 1977;18:425–31.
Kovarik J, Kuster W, Seidl G, et al. Clinical relevance of radiologic examination of the skeleton and bone density measurements in osteoporosis of old age. Skeletal Radiol 1981;7:37–41.
Ott SM, Kilcoyne RF, Chesnut CH III. Comparisons among methods of measuring bone mass and relationship to severity of vertebral fractures in osteoporosis. J Clin Endocrinol Metab 1988;66:501–7.
Meltzer M, Lessig HJ, Siegel JA. Bone mineral density and fracture in postmenopausal women. Calcif Tissue Int 1989;45:142–5.
Harrison JE, Patt N, Bayley TA, et al. Bone mineral mass associated with postmenopausal vertebral deformities. Bone Miner 1990;10:243–51.
Eastell R, Cedel SL, Wahner HZ, Riggs BL, Melton LJ III. Classification of vertebral fractures. J Bone Miner Res 1991;6:207–15.
Smith-Bindman R, Cummings SR, Steiger P, Genant HK. A comparison of morphometric definitions of vertebral fracture. J Bone Miner Res 1991;6:25–34.
Overgaard K, Hansen MA, Riis BJ, Christiansen C. Discriminatory ability of bone mass measurements (SPA and DEXA) for fractures in elderly postmenopausal women. Calcif Tissue Int 1992;50:30–5.
Haddaway MJ, Davie MWJ, McCall IW. Bone mineral density in healthy normal women and reproducibility of measurements in spine and hip using dual-energy x-ray absorptiometry. Br J Radiol 1992;65:213–7.
Cooper C, Shah S, Hand DJ, et al. Screening for osteoporosis using individual risk factors. Osteoporosis Int 1991;2:48–53.
Nicholson PHF, Haddaway MJ, Davie MWJ, Evans SF. A computerised technique for vertebral morphometry. Physiol Meas 1993 (in press).
Davies KM, Recker RR, Stegman MR, Heaney RP. Tallness versus shrinkage: do women shrink with age or grow taller with recent birth date? J Bone Miner Res 1991;6:1115–20.
Galloway A, Stini WA, Fox SC, Stein P. Stature loss among an older United States population and its relation to bone mineral status. Am J Phys Anthropol 1990;83:467–76.
Evans SF, Nicholson PHF, Haddaway MJ, Davie MWJ. Vertebral morphometry in women aged 50–81 years. Bone Miner (in press).
Black DM, Cummings SR, Stone K, Hudes E, Palermo L, Steiger P. A new approach to defining normal vertebral dimensions. J Bone Miner Res 1991;6:883–92.
Ryan PJ, Evans P, Blake GM, Fogelman I. The effect of vertebra] collapse on spinal bone mineral density measurements in osteoporosis. Bone Miner 1992;18:267–72.
Ericksen MF. Some aspects of aging in the lumbar spine. Am J Phys Anthropol 1976;45:575–80.
Britton JM, Davie MWJ. Mechanical properties of bone from iliac crest and relationship to L5 vertebral bone. Bone 1990;11:21–8.
Kleerekoper M, Nelson DA. Vertebral fracture or vertebral deformity? Calcif Tissue Int 1992;50:5–6.
Ettinger B, Block JE, Smith R, Cummings SR, Harris ST, Genant HK. An examination of the association between vertebral deformities, physical disabilities and psychosocial problems. Maturitas 1988;10:283–96.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nicholson, P.H.F., Haddaway, M.J., Davie, M.W.J. et al. Vertebral deformity, bone mineral density, back pain and height loss in unscreened women over 50 years. Osteoporosis Int 3, 300–307 (1993). https://doi.org/10.1007/BF01637315
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01637315