To test the hypothesis that thoracic kyphosis is associated with substantial pain, disability, and height loss, we measured thoracic curvature, using an architect's flexicurve, of 610 women aged 65–91 years who were recruited from population-based listings. We assessed study subjects for back pain, back-related disability, height loss since age 25 years, perceived state of health, and bone mineral density (BMD) at the spine, calcaneus, proximal radius, and distal radius. Compared with the rest of the cohort, the 10% of women with the most severe kyphosis had 7% –17% lower BMD (p<0.001) and had lost an additional 2.4 cm height (p<0.001). However, kyphotic women had no greater back pain, disability caused by back problems, or poorer health. This cross-sectional study suggests that kyphosis is associated with decreased BMD and loss of height but does not cause substantial chronic back pain, disability, or poor health in older women.
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Bergenudd H, Nilsson B, Udén A, Willner S. Bone mineral content, gender, body posture, and build in relation to back pain in middle age. Spine 1989;14:577–9.
Finsen V. Osteoporosis and back pain among the elderly. Acta Med Scand 1988;223:443–9.
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.
Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, et al. Contribution of vertebral deformities to chronic back pain and disability. J Bone Miner Res 1992;7:449–56.
Ross PD, Ettinger B, Davis JW, Melton LJ III, Wasnich RD. Evaluation of adverse health outcomes associated with vertebral fractures. Osteoporosis Int 1991;1:134–40.
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.
Nicholas JA, Wilson PD. Osteoporosis of the aged spine. Clin Orthop 1963;26:19–33.
Mellin G. Correlations of spinal mobility with degree of chronic low back pain after correction for age and anthropometric factors. Spine 1987;12:464–8.
Milne JS, Lauder IJ. Age effects in kyphosis and lordosis in adults. Ann Hum Biol 1974;1:327–37.
Milne JS, Lauder IJ. The relationship of kyphosis to the shape of vertebral bodies. Ann Hum Biol 1976;3:173–9.
Chow RK, Harrison JE. Relationship of kyphosis to physical fitness and bone mass on post-menopausal women. Am J Phys Med 1987;66:219–27.
Cummings SR, Black DM, Nevitt MC, Browner WS, Cauley JA, Genant KH, et al. Appendicular bone density and age predict hip fracture in women. JAMA 1990;263:665–8.
Steiger P, Cummings SR, Black DM, Spencer NE, Genant HK. Age-related decrements in bone mineral density in women over 65. J Bone Miner Res 1992;7:625–32.
De Smet AA, Robinson RG, Johnson BE, Lukert BP. Spinal compression fractures in osteoporotic women: patterns and relationship to hyperkyphosis. Radiology 1988;166:497–500.
Porter RW, Johnson K, McCutchan JDS. Wrist fracture, heel bone density and thoracic kyphosis: a case control study. Bone 1990;11:211–4.
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Ettinger, B., Black, D.M., Palermo, L. et al. Kyphosis in older women and its relation to back pain, disability and osteopenia: The study of osteoporotic fractures. Osteoporosis Int 4, 55–60 (1994). https://doi.org/10.1007/BF02352262
- Pain measurement
- Thoracic vertebrae