Differential involvement of the dorsal and lumbar spine in osteoporosis.

Bhambhani, M.; Crisp, A. J.; Compston, J.

doi:10.1136/ard.51.9.1069

Cited by 10 publications

(4 citation statements)

References 10 publications

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“…The mechanical stresses acting on the thoracic spine are very different from those affecting the lumbar spine and may predispose to thoracic spine disease in some individuals. The results of this study confirm previous observations in selected patients with osteoporosis [7] and demonstrate that these also apply to populationbased women. Similarly, Bernecker et al [30] recently reported that bone density in the lumbar spine did not show any correlation with the spinal deformity index, based on radiological assessment of the spine from T4 to L5, in women with post-menopausal osteoporosis.…”

Section: Discussionsupporting

confidence: 91%

“…In recent years, accurate and produce artefactually high BMD, normal lumbar spine precise assessment of bone mass at potential fracture BMD is generally interpreted as excluding spinal osteosites has become possible with techniques such as dual porosis. In a retrospective survey of 300 patients referred energy X-ray absorptiometry (DEXA), single photon for bone densitometry, we recently reported the presence absorptiometry and quantitative computed tomography, of one or more vertebral deformities in the thoracic spine Prospective studies have demonstrated an increasing in 11 patients with a normal lumbar spine assessed gradient of fracture risk with decreasing bone mineral by both bone densitometry and radiology, indicating density (BMD), a reduction of one standard deviation differential bone loss in the lumbar and thoracic spine in BMD being associated with a two to three-fold [7]. In this prospective study we have investigated the increase in fracture risk [2][3][4][5].…”

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confidence: 98%

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Vertebral deformity in the thoracic spine in post-menopausal women: value of lumbar spine bone density

Grey

Young²,

Bearcroft³

et al. 1996

The British Journal of Radiology

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Differential bone loss in the thoracic and lumbar spine is known to occur in some patients with osteoporosis. However, the discriminant value of lumbar spine bone densitometry in the detection of thoracic spine fractures in healthy, population-based women has not been established. The relationship between lumbar spine bone mineral density and thoracic spine vertebral deformities in a prospective study of 79 post-menopausal population-based women aged 45-65 years has been investigated. Lumbar spine bone mineral density was measured using dual energy X-ray absorptiometry, and vertebral morphometry was assessed from lateral thoracic spine radiographs. Seven women (9%) were found to have one or more vertebral deformities in the thoracic spine (reduction in anterior or posterior height > 25%). Only one of these had a lumbar spine bone mineral density T score below -2.5, whilst the T score was between -1 and -2.5 in three and greater than -1 in three. Two of these women also had lumbar spine vertebral deformity but lumbar spine radiographs were normal in the remaining five. There were no significant differences in age, height, weight, hormone replacement therapy use or bone mineral density between women with and without thoracic spine fractures. These results demonstrate that vertebral deformities in the thoracic spine occur in a proportion of healthy post-menopausal women in the absence of densitometric or radiographic evidence of osteoporosis in the lumbar spine. Although often asymptomatic, the significance of these fractures lies in the increased risk of further fractures. In the future, morphometric X-ray absorptiometric techniques may prove valuable in the detection of these fractures and avoid the need for conventional radiography.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 98%

Vertebral deformity in the thoracic spine in post-menopausal women: value of lumbar spine bone density

Grey

Young²,

Bearcroft³

et al. 1996

The British Journal of Radiology

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“…Secondly, measurement of bone mineral density in the spine may be affected by the presence of extraskeletal calcification, osteophytes, scoliosis, and vertebral deformity, particularly in elderly subjects 16. Thirdly, the distribution of osteoporosis within the spine may be heterogeneous, with differential involvement of the dorsal spine17; lateral radiographs of the dorsal spine should therefore be performed in addition to bone densitometry in patients who complain of loss of height or pain in the dorsal spine or who have evidence of dorsal kyphosis. Finally, osteomalacia also results in low bone mineral density measured by absorptiometric techniques and should be excluded in patients at increased risk of vitamin D deficiency and osteomalacia.…”

Section: Measurement Of Bone Massmentioning

confidence: 99%

Fortnightly Review: Bone densitometry in clinical practice

Compston

Cooper

Kanis

1995

BMJ

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158

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Summary points Osteoporosis is a major health problem in the elderly population. It causes more than 150000 fractures each year in the United Kingdom with an estimated cost of pounds sterling742 million Bone mass is a major determinant of risk of fracture and can be assessed by non-invasive techniques such as dual energy x ray absorptiometry Densitometric criteria based on standard deviation scores expressed in relation to reference values in premenopausal women (T scores) provide diagnostic categories from which thresholds for prevention and treatment can be defined on the basis of risk of fracture Population based screening for low bone mass in perimenopausal women cannot at present be justified. In clinical practice, however, bone densitometry has an important role in the diagnosis of osteoporosis in high risk groups and in the monitoring of treatment in some patients For these indications, it is estimated that about 175 bone scans per 100000 population would be needed annually, requiring an annual expenditure for the average health district of pounds sterling25200 At present, bone densitometry resources in the United Kingdom are inadequate to meet these needs. There is an urgent need to improve existing facilities so that effective strategies for the prevention and treatment of osteoporosis in clinical practice can be implemented

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“…However, the prevalence of VFs is not equally distributed across the spine [ 4 ], and in the thoracic spine, it is highest at T7–T8 and T11–T12 [ 5 – 7 ]. The reasons for this bimodal distribution of VFs remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Associations between bone attenuation and prevalent vertebral fractures on chest CT scans differ with vertebral fracture locations

et al. 2021

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Summary Vertebral fracture (VF) locations are bimodally distributed in the spine. The association between VF and bone attenuation (BA) measured on chest CT scans varied according to the location of VFs, indicating that other factors than only BA play a role in the bimodal distribution of VFs. Introduction Vertebral fractures (VFs) are associated with low bone mineral density but are not equally distributed throughout the spine and occur most commonly at T7–T8 and T11–T12 (“cVFs”) and less commonly at T4–T6 and T9–T10 (“lcVF”). We aimed to determine whether associations between bone attenuation (BA) and VFs vary between subjects with cVFs only, with lcVFs only and with both cVFs and lcVFs. Methods Chest CT images of T4–T12 in 1237 smokers with and without COPD were analysed for prevalent VFs according to the method described by Genant (11,133 vertebrae). BA (expressed in Hounsfield units) was measured in all non-fractured vertebrae (available for 10,489 vertebrae). Linear regression was used to compare mean BA, and logistic regression was used to estimate the association of BA with prevalent VFs (adjusted for age and sex). Results On vertebral level, the proportion of cVFs was significantly higher than of lcVF (5.6% vs 2.0%). Compared to subjects without VFs, BA was 15% lower in subjects with cVFs ( p < 0.0001), 25% lower in subjects with lcVFs ( p < 0.0001) and lowest in subjects with cVFs and lcVFs (− 32%, p < 0.0001). The highest ORs for presence of VFs per − 1SD BA per vertebra were found in subjects with both cVFs and lcVFs (3.8 to 4.6). Conclusions The association between VFs and BA differed according to VF location. ORs increased from subjects with cVFs to subjects with lcVFs and were highest in subjects with cVFs and lcVFs, indicating that other factors than only BA play a role in the bimodal VF distribution. Trial registration Clinicaltrials.gov identifier: NCT00292552

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Differential involvement of the dorsal and lumbar spine in osteoporosis.

Cited by 10 publications

References 10 publications

Vertebral deformity in the thoracic spine in post-menopausal women: value of lumbar spine bone density

Vertebral deformity in the thoracic spine in post-menopausal women: value of lumbar spine bone density

Fortnightly Review: Bone densitometry in clinical practice

Associations between bone attenuation and prevalent vertebral fractures on chest CT scans differ with vertebral fracture locations

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