Osteoporosis International

, Volume 15, Issue 9, pp 724–728

Impact of degenerative spinal diseases on bone mineral density of the lumbar spine in elderly women

  • Shigeyuki Muraki
  • Seizo Yamamoto
  • Hideaki Ishibashi
  • Toshiyuki Horiuchi
  • Takayuki Hosoi
  • Hajime Orimo
  • Kozo Nakamura
Original Article

Abstract

Degenerative diseases of lumbar spine commonly noted in elderly people may affect their lumbar spine bone mineral density (BMD). The aim of this study is to determine whether the degree of degenerative spinal diseases is correlated with lumbar spine and femoral neck BMD. This study included 630 women age 60 years or over (mean age 73.3 ± 6.9 years) visiting the Osteoporosis Outpatient Clinic at the Tokyo Metropolitan Geriatric Medical Center. Subjects underwent anteroposterior and lateral X-rays of the lumbar spine. The score of degenerative spinal diseases for each subject was calculated according to the scores for the Kellgren-Lawrence method, osteophyte formation, bone sclerosis, disk space narrowing, and spondylolisthesis involving L1-L2 through L4-L5 interspaces. Moreover, the number of vertebral fractures at L2 through L4 was recorded. The BMD of the second to fourth lumbar spine from anteroposterior projections and femoral neck were measured using an Expert-5000 (GE Lunar, Madison, WI USA). Most subjects had degenerative diseases of the lumbar spine. Scores for the Kellgren-Lawrence method, osteophyte formation, bone sclerosis, disk space narrowing, and spondylolisthesis were positively correlated with lumbar spine BMD, while they were not correlated with femoral neck BMD. Multiple regression analysis indicated that the scores for osteophyte formation, bone sclerosis, and disk space narrowing were independently correlated with lumbar spine BMD. Thus, in this study, the scores for degenerative spinal diseases were correlated with lumbar spine BMD, while they were not correlated with femoral neck BMD. This discrepancy indicates that degenerative spinal diseases are associated with increased lumbar spine BMD measurements. Femoral neck BMD therefore may be more appropriate than lumbar spine BMD in evaluating osteoporosis in elderly women.

Keywords

Bone mineral density Degenerative spinal diseases Diagnosis Lumbar spine Osteoporosis 

References

  1. 1.
    Paiva LC, Filardi S, Pinto-Neto AM et al (2002) Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis. Sao Paulo Med J 120(1):9–12PubMedGoogle Scholar
  2. 2.
    Dalle Carbonare L, Giannini S, Sartori L et al (2000) Lumbar osteoarthritis, bone mineral density, and quantitative ultrasound. Aging (Milan) 12(5):360–365Google Scholar
  3. 3.
    Kinoshita H, Tamaki T, Hashimoto T et al (1998) Factors influencing lumbar spine bone mineral density assessment by dual-energy X-ray absorptiometry: comparison with lumbar spinal radiogram. J Orthop Sci 3(1):3–9PubMedGoogle Scholar
  4. 4.
    Rand T, Schneider B, Grampp S et al (1997) Influence of osteophytic size on bone mineral density measured by dual X-ray absorptiometry. Acta Radiol 38(2):210–213PubMedGoogle Scholar
  5. 5.
    Vogt MT, Rubin DA, San Valentin R et al (1999) Degenerative lumbar listhesis and bone mineral density in elderly women: the study of osteoporotic fractures. Spine 24(23):2536–2541CrossRefPubMedGoogle Scholar
  6. 6.
    Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502Google Scholar
  7. 7.
    Nathan H, Israel J (1962) Osteophytes of the Vertebral Column. J Bone Joint Surg 44:243–268Google Scholar
  8. 8.
    Meyerding HW (1932) Spondylolisthesis. Surg Gynec Obstet 54:371–377Google Scholar
  9. 9.
    Inoue T (1990) [Clinical features and findings: osteoporosis] (in Japanese). Bone 4:39–47Google Scholar
  10. 10.
    Fujiwara S, Fukunaga M, Nakamura T et al (1998) Rates of change in spinal bone density among Japanese women. Calcif Tissue Int 63(3):202–207CrossRefPubMedGoogle Scholar
  11. 11.
    Fisher ES, Baron JA, Malenka DJ et al. Hip fracture incidence and mortality in New England. Epidemiology 1991; 2(2):116–22Google Scholar
  12. 12.
    Magaziner J, Simonsick EM, Kashner TM et al (1989) Survival experience of aged hip fracture patients. Am J Public Health 79(3):274–278PubMedGoogle Scholar
  13. 13.
    Pitto RP (1994) The mortality and social prognosis of hip fractures: a prospective multifactorial study. Int Orthop 18(2):109–113PubMedGoogle Scholar
  14. 14.
    Bouxsein ML, Palermo L, Yeung C et al (2002) Digital X-ray radiogrammetry predicts hip, wrist and vertebral fracture risk in elderly women: a prospective analysis from the study of osteoporotic fractures. Osteoporos Int 13(5):358–365CrossRefGoogle Scholar
  15. 15.
    Cummings SR, Bates D, Black DM (2002) Clinical use of bone densitometry: scientific review. JAMA 288(15):1889–1897CrossRefPubMedGoogle Scholar
  16. 16.
    Kanis JA (2002) Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359:1929–1936CrossRefPubMedGoogle Scholar
  17. 17.
    Kanis JA (2000) An update on the diagnosis and assessment of osteoporosis with densitometry. Osteoporos Int 11:192–202CrossRefPubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • Shigeyuki Muraki
    • 1
    • 3
  • Seizo Yamamoto
    • 1
  • Hideaki Ishibashi
    • 1
  • Toshiyuki Horiuchi
    • 2
  • Takayuki Hosoi
    • 2
  • Hajime Orimo
    • 2
  • Kozo Nakamura
    • 3
  1. 1.Department of Orthopedic SurgeryTokyo Metropolitan Geriatric Medical CenterTokyoJapan
  2. 2.Department of EndocrinologyTokyo Metropolitan Geriatric Medical CenterTokyoJapan
  3. 3.Department of Orthopedic SurgeryTokyo University School of MedicineTokyoJapan

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