Article

Morphometric vertebral fractures of the lower thoracic and lumbar spine, physical function and quality of life in men

Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia.
Osteoporosis International (Impact Factor: 4.17). 10/2008; 20(5):787-92. DOI: 10.1007/s00198-008-0744-6
Source: PubMed

ABSTRACT The epidemiology and sequelae of morphometric vertebral fracture (MVF) are poorly documented. We found that MVFs of the lower thoracic and lumbar spine were associated with poor quality of life and impaired physical function in men. We recommend that morphometric X-ray absorptiometry be included in routine requests for bone densitometry.
Vertebral fractures are sentinel events for osteoporosis. We aimed to compare quality of life and physical function in men with and without MVF.
Using morphometric X-ray absorptiometry (T10-L4), MVFs were identified in a random sample of men aged 20-93 years. Moderate and severe wedge, biconcave or compression deformities (>25% reduction in any vertebral height) were classified as MVFs.
Of 1,147 men, MVFs were identified in 64. No MVFs were detected for men in their twenties. Prevalence was 1.5% for 30-39 years, 1.4% 40-49 years, 3.2% 50-59 years, 4.7% 60-69 years, 10.0% 70-79 years and 14.6% 80+ years. Among 555 men aged 60+ years, those with MVFs were twice as likely to have quality of life scores in the lowest tertile (age-adjusted OR = 2.35, 95%CI 1.24-4.45). MVFs were associated with lower mean age-adjusted physical activity scores [11.3 (95%CI 9.0-13.8) vs 14.0 (13.2-14.9), P = 0.04] and longer mean age-adjusted 'Up-&-Go' times [9.5 (8.9, 10.1) vs 8.9 (8.8, 9.1) s, P = 0.06].
Despite most men being unaware of their condition, MVFs were associated with poor quality of life and impaired physical function. We recommend that morphometric X-ray absorptiometry be included in routine requests for bone densitometry because detection of MVFs has important implications for osteoporosis management in men.

Download full-text

Full-text

Available from: Mark A Kotowicz, Jul 30, 2015
0 Followers
 · 
235 Views
  • Source
    • "Patients with VFx suffer a negative impact, with deterioration of their quality of life, and loss of both functional capacity and independence [18] [19] [20] [21]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Vertebral deformities are associated with a marked increase in morbidity, mortality, and burden in terms of sanitary expenditures. Patients with vertebral fractures have a negative impact in their health, less quality of life, and loss of functional capacity and independence. The purpose of this study was to explore the vulnerability of healthy vertebrae in patients who have sustained already a compression fracture and in patients who do not have prevalent fractures in the thoracic spine; and to explore the association of the deformity in healthy vertebrae with different variables, such as bone mineral density (BMD), body mass index, age, loss of height, presence of clinical kyphosis, history of other osteoporotic fractures, and falls occurring during the last year. Clinical data and complementary studies from 175 postmenopausal outpatients were analyzed. These women (age: 69.7±11.1 years) had not received any treatment for osteoporosis. Anteroposterior and lateral radiographs of the thoracic spine and bone densitometry of the hip were obtained; morphometry was performed in 1575 thoracic vertebrae from T4 to T12. The angle of wedging of each vertebral body was calculated using a trigonometric formula. Then, the sum of wedge angles of vertebral bodies (SWA) was determined, and Cobb angle was measured. In patients with vertebral fractures, after excluding the angles of fractured vertebral bodies, the mean wedge angle of the remaining vertebrae (MWAhealthy) was calculated. The same procedure was followed in patients without vertebral fractures. MWAhealthy was considered as an indicator of the structural vulnerability of non-fractured vertebrae. Patients with prevalent fractures had lower BMD, wider Cobb angle, and higher sum of wedge angles than patients without vertebral fractures. The proportion of patients with accentuation of clinical kyphosis was higher in the group with prevalent vertebral fractures. A highly significant difference was found in the MWAhealthy, which was higher in patients with prevalent fractures (4.1±1.3° vs. 3.0±1.1°; p<0.001). Patients showing vertebral fractures had 7.1±4.2 cm height loss in average, significantly superior than that found among non-fractured women (3.6±3.2 cm; p<0.01). In multivariate analysis, the increase of MWAhealthy was associated with advancing age (p<0.02), lower femoral neck BMD (p<0.005), presence of clinical kyphosis (p<0.01) and vertebral fractures (p<0.02). This study presents evidence that a series of factors independently influence the increase in wedging deformity of vertebral bodies that are not fractured yet. These factors could contribute to an increased vulnerability of the vertebrae, making them more susceptible to fracture.
    Bone 12/2010; 48(4):820-7. DOI:10.1016/j.bone.2010.12.014 · 4.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Thesis (M.A.)--University of the Pacific, 2005. Includes abstract. Includes bibliographical references (leaves 217-228).
  • [Show abstract] [Hide abstract]
    ABSTRACT: A short review of Al-related point deflects and their radiation effects is presented. These defects exhibit spectroscopic signals which are monitored by a variety of experimental techniques. This discussion is useful to prospective researchers in the area of precision quartz resonators for frequency control in aerospace applications. Irradiation of quartz crystals at 77 K before and after irradiation at 300 K coupled with sweeping can be used for estimating the role of various point defects for their contribution in estimating the frequency offsets in quartz crystals in a radiation environment.
    Frequency Control Symposium and Exposition, 2004. Proceedings of the 2004 IEEE International; 09/2004
Show more