Mann T, Oviatt S K, Wilson D, Nelson D, Orwoll E S
Bone and Mineral Research Unit, Portland Veterans Administration Medical Center, Oregon Health Sciences University.
J Bone Miner Res. 1992 Nov;7(11):1259-65. doi: 10.1002/jbmr.5650071120.
Vertebral fracture is the most prevalent manifestation of osteoporosis in women, but there is very little information concerning vertebral fracture in men. These studies begin to determine the prevalence, radiographic character, and relationship to bone mineral density of vertebral deformity in men. A group of 144 white men aged 34-94 years (83% between 50 and 80 years) were studied. Thoracic and lumbar spine radiographs were obtained using standardized techniques, and morphometric measures of vertebrae (T6-L5) were obtained using a computerized digitization pad. Vertebral deformities (wedge, midbody, and crush) were identified using several criteria. In addition, a skeletal radiologist independently identified vertebral deformities, as well as vertebrae affected by epiphysitis (Scheuermann's disease), using classic radiographic criteria. Bone mineral density was measured at lumbar spine and proximal femoral sites using dual-photon absorptiometry. The prevalence of vertebral deformity was related to the criteria used for their identification. Utilizing vertebral-specific criteria (anterior/posterior or midbody/posterior vertebral height more than 3 SD below vertebral specific mean), 10% of subjects had vertebral deformity. Wedge deformity occurred primarily in thoracic vertebrae and were more common than midbody deformity, which occurred more commonly in lumbar vertebrae. Crush deformities were not observed. Evidence of vertebral epiphysitis was present in 9% of subjects but was not responsible for vertebral deformity sufficient to be falsely identified using the more than -3 SD criterion. Bone mineral density in subjects with vertebral deformity was clearly reduced at both vertebral (p = 0.003) and proximal femoral (p = 0.002) measurements sites. The number of vertebral deformities was negatively correlated with vertebral bone mineral density.(ABSTRACT TRUNCATED AT 250 WORDS)
椎体骨折是女性骨质疏松最常见的表现,但关于男性椎体骨折的信息却非常少。这些研究开始确定男性椎体畸形的患病率、影像学特征及其与骨密度的关系。对一组144名年龄在34 - 94岁的白人男性(83%在50至80岁之间)进行了研究。采用标准化技术获取胸腰椎X线片,并使用计算机数字化平板获取椎体(T6 - L5)的形态测量数据。使用多种标准识别椎体畸形(楔形、椎体中部和压缩性)。此外,一名骨骼放射科医生使用经典影像学标准独立识别椎体畸形以及受骨骺炎(休曼病)影响的椎体。使用双能光子吸收法测量腰椎和股骨近端部位的骨密度。椎体畸形的患病率与用于识别它们的标准有关。采用椎体特异性标准(椎体前后或椎体中部/椎体后部高度比椎体特异性平均值低3个标准差以上)时,10%的受试者有椎体畸形。楔形畸形主要发生在胸椎,比椎体中部畸形更常见,椎体中部畸形在腰椎更常见。未观察到压缩性畸形。9%的受试者存在椎体骨骺炎证据,但不足以导致使用超过 - 3标准差标准被错误识别的椎体畸形。椎体畸形受试者的椎体(p = 0.003)和股骨近端(p = 0.002)测量部位的骨密度明显降低。椎体畸形的数量与椎体骨密度呈负相关。(摘要截短至250字)