Long-term observations of vertebral fractures in spinal osteoporotics

Itoi, Eiji; Sakurai, Minoru; Mizunashi, Kazutoshi; Satô, Kôzô; Kasama, Fumio

doi:10.1007/bf02555920

Cited by 28 publications

(10 citation statements)

References 6 publications

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“…In this study, the middle height, concavity index, lumbar spine score, and relative central compression, all of which represent the degree of biconcavity, showed significant positive correlations with the BMD. Wedge fracture is common in the thoracic spine [20,25] and may be related to the severity of osteoporosis [25]. Contrary to our expectation, these correlations were not strong as indicated by the small correlation coefficients.…”

Section: Discussioncontrasting

confidence: 98%

“…Wedge index =Ha/Hp • 100 Concavity index =Hm/Hp • 100 Lumbar spine score [18] =Hm/Ha • 100 Relative central compression (modified from Hangartner [19]) = 2Hm/(Ha + Hp) • 100 With these indices, fractures were classified into three types: wedge fracture (a decrease in the wedge index more than 20~ biconcave fracture (a decrease in the concavity index more than 20%o) ; and compression fracture (a decrease in anterior and posterior height more than 25~ compared with adjacent vertebrae} [20].…”

Section: Methodsmentioning

confidence: 99%

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Vertebral shape, trabecular pattern, and spinal bone mineral density in osteoporosis

et al. 1994

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zt bstract : Vertebral morphometry and trabecular pattern were correlated to the bone mineral density (BMD) of the corresponding vertebra in 82 patients with osteoporosis. With lateral roentgenograms of the lumbar spine, the anterior, middle, and posterior vertebral heights of L2, L3, and L4 were measured, and the wedge index, concavity index, lumbar spine score, and relative central compression were calculated. The trabecular pattern was graded from normal to a disappearance of trabeculae. The BMD of the corresponding vertebrae was measured by dual photon absorptiometry. There were positive correlations between the BMD and the following measurements of biconcavity: the middle height @=0.182, p=0.0086), concavity index (r=0.202, p=0.0034), lumbar spine score (r=0.147, p-0.0343), and relative central compression (r =0.179, p=0.0099). The trabecular patt~ern showed a negative correlation with the BMD (r =-0.141, p=0.0428). Although these correlations were statistically significant, the correlation coefficients and the coefficients of determination were small. Therefore, we may be able to use the degree of biconcavity and the trabecular pattern to differentiate severe osteoporosis from mild one, but these parameters are of limited value in the precise assessment of bone loss.

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Section: Discussioncontrasting

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Vertebral shape, trabecular pattern, and spinal bone mineral density in osteoporosis

et al. 1994

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“…Because of bone fragility, vertebral fracture occurs commonly in patients with osteoporosis. Initial vertebral fracture usually occurs at the midthoracic or thoracolumbar spine as a wedge fracture [4,17]. As osteoporosis advances, biconcavity fractures more commonly occur at the lumbar spine.…”

Section: Axial Deformitiesmentioning

confidence: 99%

The Role of Exercise in the Treatment of Osteoporosis

Sinaki

Pfeifer²,

Preisinger

et al. 2010

Curr Osteoporos Rep

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The objective of exercise in the treatment of osteoporosis is to improve axial stability through improvement of muscle strength. Therefore, a back extension exercise program specific to one's musculoskeletal competence and pain can be performed in a sitting position and later advanced to the prone position. When fragility is resolved, back extension is performed against resistance applied to the upper back. To decrease pain and immobility in acute vertebral fracture, use of spinal orthoses become inevitable. Therapeutic exercise should address osteoporosis-related deformities of axial posture, which can increase risk of fall and fracture. Strengthening of the major appendicular muscles decreases fragility. The effect of strengthening exercise is augmented by proper intake of cholecalciferol and calcium. Thus, the role of a therapeutic exercise program is to increase muscle strength safely, decrease immobility-related complications, and prevent fall and fracture. As with pharmacotherapy, therapeutic exercises are individualized.

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“…Because of bone loss and postural changes, vertebral fractures can occur more readily in persons with osteoporosis. On the basis of the biomechanics of the spine, the most common areas of compression with spinal flexion are the mid‐thoracic, thoracolumbar, and upper lumbar spine, the result of which is a wedge or compression fracture 1,17 …”

Section: Discussionmentioning

confidence: 99%

“…On the basis of the biomechanics of the spine, the most common areas of compression with spinal flexion are the mid-thoracic, thoracolumbar, and upper lumbar spine, the result of which is a wedge or compression fracture. 1,17 When osteoporosis or osteopenia results in spinal deformities, especially kyphosis, the other areas of the spine maintain axial body equilibrium by accommodating to these malalignments through changes in their alignment. The area of fracture defines the postural deformity.…”

Section: Discussionmentioning

confidence: 99%

Yoga Spinal Flexion Positions and Vertebral Compression Fracture in Osteopenia or Osteoporosis of Spine: Case Series

Sinaki

2012

Pain Practice

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Objective: The objective of this report is to raise awareness of the effect of strenuous yoga flexion exercises on osteopenic or osteoporotic spines. We previously described subjects with known osteoporosis in whom vertebral compression fractures (VCFs) developed after spinal flexion exercise (SFE) and recommended that SFEs not be prescribed in patients with spinal osteoporosis. Methods: This report describes 3 healthy persons with low bone mass and yoga-induced pain or fracture. Results: All 3 patients had osteopenia, were in good health and pain-free, and had started yoga exercises to improve their musculoskeletal health. New pain and fracture areas occurred after participation in yoga flexion exercises. Conclusions: The development of pain and complications with some flexion yoga positions in the patients with osteopenia leads to concern that fracture risk would increase even further in osteoporosis. Although exercise has been shown to be effective for improving bone mineral density and decreasing fracture risk, our subjects had development of VCFs and neck and back pain with yoga exercises. This finding suggests that factors other than bone mass should be considered for exercise counseling in patients with bone loss. The increased torque pressure applied to vertebral bodies during SFEs may be a risk. Exercise is effective and important for treatment of osteopenia and osteoporosis and should be prescribed for patients with vertebral bone loss. Some yoga positions can contribute to extreme strain on spines with bone loss. Assessment of fracture risk in older persons performing SFEs and other high-impact exercises is an important clinical consideration. n

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Long-term observations of vertebral fractures in spinal osteoporotics

Cited by 28 publications

References 6 publications

Vertebral shape, trabecular pattern, and spinal bone mineral density in osteoporosis

Vertebral shape, trabecular pattern, and spinal bone mineral density in osteoporosis

The Role of Exercise in the Treatment of Osteoporosis

Yoga Spinal Flexion Positions and Vertebral Compression Fracture in Osteopenia or Osteoporosis of Spine: Case Series

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