Determinants of the size of incident vertebral deformities in European men and women in the sixth to ninth decades of age: The European Prospective Osteoporosis Study (EPOS)

被引：29

作者：

Reeve, J ^{[1
]}

Lunt, M ^{[1
]}

Felsenberg, D ^{[1
]}

Silman, AJ ^{[1
]}

Scheidt-Nave, C ^{[1
]}

Poor, G ^{[1
]}

Gennari, C ^{[1
]}

Weber, K ^{[1
]}

Lorenc, R ^{[1
]}

Masaryk, P ^{[1
]}

Cannata, JB ^{[1
]}

Dequeker, J ^{[1
]}

Reid, DM ^{[1
]}

Pols, HAP ^{[1
]}

Benevolenskaya, LI ^{[1
]}

Stepan, JJ ^{[1
]}

Miazgowski, T ^{[1
]}

Bhalla, A ^{[1
]}

Armas, JB ^{[1
]}

Eastell, R ^{[1
]}

Lopes-Vaz, A ^{[1
]}

Lyritis, G ^{[1
]}

Jajic, I ^{[1
]}

Woolf, AD ^{[1
]}

Banzer, D ^{[1
]}

Reisinger, W ^{[1
]}

Todd, CJ ^{[1
]}

Felsch, B ^{[1
]}

Havelka, S ^{[1
]}

Hoszowski, K ^{[1
]}

Janott, J ^{[1
]}

Johnell, O ^{[1
]}

Raspe, HH ^{[1
]}

Yershova, OB ^{[1
]}

Kanis, JA ^{[1
]}

Armbrecht, G ^{[1
]}

Finn, JD ^{[1
]}

Gowin, W ^{[1
]}

O'Neill, TW ^{[1
]}

机构：

[1] Addenbrookes Hosp, Dept Med, Cambridge CB2 2QQ, England

来源：

JOURNAL OF BONE AND MINERAL RESEARCH | 2003年 / 18卷 / 09期

关键词：

osteoporosis; vertebral fractures; cohort study; radiological morphometry; fracture risk;

D O I：

10.1359/jbmr.2003.18.9.1664

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: According to Euler's buckling theory, loss of horizontal trabeculae in vertebrae increases the risk of fracture and suggests that the extent of vertebral collapse will be increased in proportion. We tested the hypothesis that the characteristics of a baseline deformity would influence the size of a subsequent deformity. Methods: In 207 subjects participating in the European Prospective Osteoporosis Study who suffered an incident spine fracture in a previously normal vertebra, we estimated loss of volume (fracture size) from plane film images of all vertebral bodies that were classified as having a new fracture. The sum of the three vertebral heights (anterior, mid-body, and posterior) obtained at follow-up was subtracted from the sum of the same measures at baseline. Each of the summed height loss for vertebrae with a McCloskey-Kanis deformity on the second film was expressed as a percentage. Results and Conclusions: In univariate models, the numbers of baseline deformities and the clinical category of the most severe baseline deformity were each significantly associated with the size of the most severe incident fracture and with the cumulated sum of all vertebral height losses. In multivariate modeling, age and the clinical category of the baseline deformity (crush > bi-concave > uni-concave > wedge) were the strongest determinants of both more severe and cumulative height loss. Baseline biconcave and crush fractures were associated at follow-up with new fractures that were approximately twice as large as those seen with other types of deformity or who previously had undeformed spines. In conclusion, the characteristics of a baseline vertebral deformity determines statistically the magnitude of vertebral body volume lost when a subsequent fracture occurs. Because severity of fracture and number of fractures are determinants of impact, the results should improve prediction of the future personal impact of osteoporosis once a baseline prevalent deformity has been identified.

引用

页码：1664 / 1673

页数：10

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