Leidig-Bruckner G, Genant H K, Minne H W, Storm T, Thamsborg G, Bruckner T, Sauer P, Schilling T, Soerensen O H, Ziegler R
Department of Internal Medicine I, University of Heidelberg, Germany.
Osteoporos Int. 1994 May;4(3):154-61. doi: 10.1007/BF01623062.
There is no agreed definition for the assessment of vertebral fractures and deformities in patients with osteoporosis. Radiographs of 66 patients randomized for therapy with etidronate or placebo were analyzed at baseline and during follow-up (60/120/150 weeks) independently using two procedures. The first method of spinal deformity index (SDIG) and vertebral deformity score (VDSG) is based on a semiquantitative visual reading of each vertebra between T4 and L4. The second method of spine deformity index (SDIM) and vertebral deformity index (VDIM) is based on vertebral height measurements of T4 through L5 and each measurement from T5 to L5 (anterior, middle and posterior height) is related to T4 and compared with the respective T4-related normal range. There was good agreement between the mean vertebral deformation from T5 to L4 graded by VDSG and VDIM, with correlation coefficients between R = 0.52 (p < 0.0001) and R = 0.9 (p < 0.0001) respectively. Spinal deformation at baseline as measured by SDIM and SDIG was correlated with R = 0.76 (p < 0.0001). For diagnosing a vertebra as fractured or not, VDIM reached a sensitivity of 82% and a specificity of 85% using VDSG as a standard, and on the other hand VDSG reached a sensitivity of 78% and a specificity of 88% in relation to VDIM. The changes in spinal deformation from week 0 to 150 were correlated with R = 0.58 (p < 0.0002) between SDIM and SDIG. To detect vertebral fracture progression the sensitivity of VDIM was 74% and the specificity 86%, when changes in VDSG were used as a standard.(ABSTRACT TRUNCATED AT 250 WORDS)
对于骨质疏松症患者椎骨骨折和畸形的评估，目前尚无公认的定义。对66例随机接受依替膦酸盐或安慰剂治疗的患者的X光片，在基线期以及随访期间（60/120/150周）分别采用两种方法进行独立分析。第一种方法是脊柱畸形指数（SDIG）和椎体畸形评分（VDSG），基于对T4至L4之间每个椎体的半定量视觉读数。第二种方法是脊柱畸形指数（SDIM）和椎体畸形指数（VDIM），基于对T4至L5椎体高度的测量，并且从T5到L5的每次测量（前、中、后高度）均与T4相关，并与各自的T4相关正常范围进行比较。VDSG和VDIM对T5至L4椎体平均变形程度的分级结果具有良好的一致性，相关系数分别为R = 0.52（p < 0.0001）和R = 0.9（p < 0.0001）。SDIM和SDIG在基线期测量的脊柱变形程度相关系数为R = 0.76（p < 0.0001）。以VDSG为标准时，VDIM诊断椎体是否骨折的敏感性为82%，特异性为85%；另一方面，以VDIM为标准时，VDSG的敏感性为78%，特异性为88%。从第0周至150周，SDIM和SDIG测量的脊柱变形变化的相关系数为R = 0.58（p < 0.0002）。以VDSG的变化为标准时，检测椎体骨折进展的VDIM敏感性为74%，特异性为86%。（摘要截选至250字）
