Davies K M, Recker R R, Heaney R P
Department of Medicine, Creighton University, Omaha, Nebraska.
Osteoporos Int. 1993 Sep;3(5):265-70. doi: 10.1007/BF01623831.
In order to study vertebral fractures in various study populations, we earlier prepared a database of vertebral dimensions derived from spinal radiographs of 191 normal women seen regularly over 25 years. In this report we have expanded the range of measurements to include vertebral levels T3 to L5. We report means and standard deviations on anterior and posterior heights, on wedge shape and on heights relative to adjacent vertebrae. When one or both of the latter two quantities are 'far' below the mean, a vertebra is called deformed. We also describe a more flexible way of expressing damage using the number of deformed vertebrae, the degree of deformity of individual vertebrae, or the total damage to the entire spine. In assessing damage we use criteria for deformity adjusted to the limits detected by an experienced diagnostician, replacing an earlier approach based on 95% probability limits of normal variation. The normal women from whom these variations are ascertained are a low-prevalence group with respect to vertebral deformity, with prevalence of 2.8%. When the criteria developed from these women were applied to a moderate-prevalence group (37%) the model had a sensitivity of 97%, a specificity of 89% and an accuracy of 92% as regards the identification of subjects with damaged vertebrae. When used epidemiologically for a moderate-prevalence group the model has a known overestimation of 15%. the model is compared with other schemes for identifying vertebral deformities.
为了研究不同研究人群中的椎体骨折情况，我们之前建立了一个椎体尺寸数据库，该数据库源自对191名正常女性在25年期间定期拍摄的脊柱X光片。在本报告中，我们扩大了测量范围，将T3至L5椎体水平纳入其中。我们报告了椎体前后高度、楔形形状以及相对于相邻椎体高度的均值和标准差。当后两个量中的一个或两个“远”低于均值时，该椎体被称为变形椎体。我们还描述了一种更灵活的方式来表达损伤情况，即使用变形椎体的数量、单个椎体的畸形程度或整个脊柱的总损伤程度。在评估损伤时，我们使用了根据经验丰富的诊断医生所检测到的限度进行调整的畸形标准，取代了基于正常变异95%概率限度的早期方法。确定这些变异的正常女性在椎体畸形方面属于低患病率群体，患病率为2.8%。当将从这些女性中得出的标准应用于中度患病率群体（37%）时，该模型在识别椎体受损受试者方面的灵敏度为97%，特异度为89%，准确率为92%。当在流行病学中用于中度患病率群体时，该模型已知高估了15%。将该模型与其他识别椎体畸形的方案进行了比较。
