Minne H W, Leidig G, Wüster C, Siromachkostov L, Baldauf G, Bickel R, Sauer P, Lojen M, Ziegler R
University of Heidelberg, Department of Internal Medicine I, Endocrinology and Metabolism, FRG.
Bone Miner. 1988 Mar;3(4):335-49.
The available methods to quantitate vertebral deformity in osteoporotics are not satisfactory in comparing follow-up measurements in patients. This paper describes a newly developed 'spine deformity index' (SDI) which allows the quantitation of the extent of vertebral fractures. It is based on the observation that, in 110 normal persons, the heights of all vertebral bodies were related to each other in a predictable and constant manner. This relation was independent of the body height of the individual and was preserved despite growth acceleration during the last century. Since in all but one of our osteoporotic patients the 4th thoracic vertebra was unfractured we were able to compare the actual size of their fractured vertebrae to the calculated presumable original heights. The differences between presumable original and actual heights gave a measure of the extent of vertebral compression and allowed to define an index representing the sum of all spinal fractures in osteoporotics. The method was applied retrospectively to X-rays of 39 patients with idiopathic osteoporosis. Thirty-two of them were treated orally with 80 mg sodium fluoride, 1,000 mg calcium and 3000 IE vitamin D daily. Treatment resulted in a reduction of the progression of vertebral deformity. Seven inadequately treated patients had more pronounced progression of vertebral deformity.
在比较骨质疏松症患者的随访测量结果时，现有的定量椎体畸形的方法并不令人满意。本文描述了一种新开发的“脊柱畸形指数”（SDI），它可以对椎体骨折的程度进行定量。它基于这样的观察结果：在110名正常人中，所有椎体的高度以可预测且恒定的方式相互关联。这种关系与个体的身高无关，并且尽管在上个世纪生长加速，这种关系仍然保持。由于在我们所有的骨质疏松症患者中，除了一名患者外，第四胸椎均未骨折，因此我们能够将他们骨折椎体的实际大小与计算得出的假定原始高度进行比较。假定原始高度与实际高度之间的差异给出了椎体压缩程度的度量，并允许定义一个代表骨质疏松症患者所有脊柱骨折总和的指数。该方法被回顾性地应用于39例特发性骨质疏松症患者的X线片。其中32例患者每天口服80毫克氟化钠、1000毫克钙和3000国际单位维生素D。治疗导致椎体畸形进展的减少。7例治疗不充分的患者椎体畸形进展更为明显。
