Osteoporosis International

, Volume 3, Issue 3, pp 113–119 | Cite as

Prevalence and incidence of vertebral deformities

  • L. J. MeltonIII
  • A. W. Lane
  • C. Cooper
  • R. Eastell
  • W. M. O'Fallon
  • B. L. Riggs
Original Article

Abstract

There is a need to identify vertebral fractures from radiographs taken at a single point in time, but considerable controversy surrounds the methods to be used. We extended a data set to comprise baseline radiographs of the thoracic and lumbar spine on an age-stratified random sample of 762 Rochester, Minnesota, women and used revised methods to define vertebral deformities morphometrically. Changes in the method of measuring vertebral heights, changes in the source of normal values for vertebral measurements and changes in the criteria for assessing vertebral deformity had little impact on estimated prevalence and incidence in this population. The prevalence of any vertebral deformity was estimated at 25.3 per 100 Rochester women aged 50 years and over (95% CI, 22.3–28.2), while the incidence of a new deformity in this group was estimated at 17.8 per 1000 person-years (95% CI, 16.0–19.7). Projected nationally, these data suggest that over 500 000 white women in the United States develop vertebral deformities for the first time each year and that over 7 million white women aged 50 years and over might be affected at any given time. These estimates are limited by the absence of a reliable ‘gold standard’ with which to determine false positive and false negative rates associated with this or any other morphometric method. Information on the health consequences of vertebral deformities of various sorts would be most helpful in choosing between alternative approaches to defining them.

Keywords

Epidemiology Incidence Osteoporosis Prevalence Vertebral fracture 

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References

  1. 1.
    Cooper C, Atkinson EJ, O'Fallon WM, Melton LJ III. Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 1992;7:221–7.Google Scholar
  2. 2.
    Melton LJ III, Kan SH, Frye MA, Wahner HW, O'Fallon WM, Riggs BL. Epidemiology of vertebral fractures in women. Am J Epidemiol 1989;129:1000–11.Google Scholar
  3. 3.
    Cooper C, Melton LJ III. Epidemiology of osteoporosis. Trends Endocrinol Metab 1992;3:224–9.Google Scholar
  4. 4.
    Kurland LT, Molgaard CA. The patient record in epidemiology. Sci Am 1981;245:54–63.Google Scholar
  5. 5.
    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.Google Scholar
  6. 6.
    Eastell R, Cedel SL, Wahner HW, Riggs BL, Melton LJ III. Classification of vertebral fractures. J Bone Miner Res 1991;6:207–15.Google Scholar
  7. 7.
    Leske MC, Ederer F, Podgor M. Estimating incidence from age-specific prevalence in glaucoma. Am J Epidemiol 1981;113:606–13.Google Scholar
  8. 8.
    Genant HK, Vogler JB, Block JE. Radiology of osteoporosis. In: Riggs BL, Melton LJ III, editors. Osteoporosis: etiology, diagnosis, and management. New York: Raven Press, 1988:181–220.Google Scholar
  9. 9.
    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.Google Scholar
  10. 10.
    Hurxthal LM, Vose GP, Dotter WE. Densitometric and visual observations of spinal radiographs. Geriatrics 1969;24:93–106.Google Scholar
  11. 11.
    Davies KM, Recker RR, Heaney RP. Normal vertebral dimension and normal variation in serial measurements of vertebrae. J Bone Miner Res 1989;4:341–9.Google Scholar
  12. 12.
    Cooper C, Shah S, Hand DJ, Adams J, Compston J, Davie M, Woolf A (The Multicentre Vertebral Study Group). Screening for vertebral osteoporosis using individual risk factors. Osteoporosis Int 1991;2:48–53.Google Scholar
  13. 13.
    Sauer P, Leidig G, Minne H, Duckeck G, Schwarz W, Siromach-kostov L, Ziegler R. Spine deformity index (SDI) versus other objective procedures of vertebral fracture identification in patients with osteoporosis: a comparative study. J Bone Miner Res 1991;6:227–38.Google Scholar
  14. 14.
    Cooper C, Melton LJ. Vertebral fractures: how large is the silent epidemic? BMJ 1992;304:793–4.Google Scholar
  15. 15.
    Ross PD, Wasnich RD, MacLean CJ, Hagino R, Vogel JM. A model for estimating the potential costs and savings of osteoporosis prevention strategies. Bone 1988;9:337–47.Google Scholar
  16. 16.
    Parfitt AM, Duncan H. Metabolic bone disease affecting the disease. In: Rothman RH, Simeone FA, editors. The spine. 2nd ed. Philadelphia: Saunders, 1982:775–905.Google Scholar
  17. 17.
    Gershon-Cohen J, Rechtman AM, Schraer H, Blumberg N. Asymptomatic fractures in osteoporotic spines of the aged. JAMA 1953;153:625–7.Google Scholar
  18. 18.
    Urist MR. Orthopaedic management of osteoporosis in postmenopausal women. Clin Endorcrinol Metab 1973;2:159–76.Google Scholar
  19. 19.
    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.Google Scholar
  20. 20.
    Finsen V. Osteoporosis and back pain among the elderly. Acta Med Scand 1988;223:443–9.Google Scholar
  21. 21.
    Leidig G, Minne HW, Sauer P, Wüster C, Wüster J, Lojen M, et al. A study of complaints and their relation to vertebral destruction in patients with osteoporosis. Bone Miner 1990;8:217–29.Google Scholar
  22. 22.
    Watts NB, Genant HK, Harris ST, Jackson RD, Licata AA, Miller PD, et al. Clinical correlates of radiographic apparent vertebral fractures. [abstract]. Calcif Tissue Int 1991; 48[Suppl]:A39.Google Scholar
  23. 23.
    Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK, and The Study of Osteoporotic Fractures Research Group. Contribution of vertebral deformities to chronic back pain and disability. J Bone Miner Res 1992;7:449–56.Google Scholar
  24. 24.
    Frost HM. Clinical management of the symptomatic osteoporotic patient. Orthop Clin North Am 1981;12:671–81.Google Scholar
  25. 25.
    Lyritis GP, Mayasis B, Tsakalakos N, Lambropoulos A, Gazi S, Karachalios T, et al. The natural history of the osteoporotic vertebral fracture. Clin Rheumatol 1989;8[Suppl 2]:66–9.Google Scholar
  26. 26.
    Ross PD, Davis JW, Epstein RS, Wasnich RD. Ability of vertebral dimensions from a single radiograph to identify fractures. Calcif Tissue Int 1992;51:95–9.Google Scholar
  27. 27.
    Ross PD, Davis JW, Vogel JM, Wasnich RD. A critical review of bone mass and the risk of fractures in osteoporosis. Calcif Tissue Int 1990;46:149–61.Google Scholar

Copyright information

© European Foundation for Osteoporosis 1993

Authors and Affiliations

  • L. J. MeltonIII
    • 1
  • A. W. Lane
    • 1
  • C. Cooper
    • 1
  • R. Eastell
    • 2
  • W. M. O'Fallon
    • 1
  • B. L. Riggs
    • 2
  1. 1.Section of Clinical Epidemiology, Department of Health Sciences ResearchMayo ClinicRochesterUSA
  2. 2.Division of Endocrinology/Metabolism and Internal MedicineMayo Clinic and FoundationRochesterUSA

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