Wasnich R D
Hawaii Osteoporosis Center, Honolulu 96814, USA.
Bone. 1996 Mar;18(3 Suppl):179S-183S. doi: 10.1016/8756-3282(95)00499-8.
Vertebral fractures are the most common but least understood of all osteoporotic fractures. Their study has been hampered by the lack of a common morphometric definition, and the fact that many vertebral fractures are asymptomatic and not clinically evident. Population-based radiographic surveys are therefore required for comparative studies. Risk factors fall into five major categories: (1) age, or age-related, (2) genetic, (3) environmental, (40 endogenous hormones or chronic diseases, and (5) physical characteristics of bone. Bone density is the most clinically useful risk factor, particularly for purposes of prevention. Because vertebral fracture prevalence parallels levels of bone density, bone density is also useful for epidemiological surveys. Based on WHO diagnostic criteria, 54% of postmenopausal white women in the United States have osteopenia, and another 30% have osteoporosis. Existing fractures are also strong, independent predictors of future vertebral fracture risk, but also represent a later, and less treatable, stage of the disease.
椎体骨折是所有骨质疏松性骨折中最常见但却最不为人所了解的。对它们的研究因缺乏一个通用的形态计量学定义以及许多椎体骨折无症状且在临床上不明显这一事实而受到阻碍。因此，基于人群的影像学调查对于比较研究来说是必需的。风险因素可分为五大类：（1）年龄或与年龄相关的因素，（2）遗传因素，（3）环境因素，（4）内源性激素或慢性疾病，以及（5）骨骼的物理特征。骨密度是临床上最有用的风险因素，尤其是在预防方面。由于椎体骨折患病率与骨密度水平平行，骨密度在流行病学调查中也很有用。根据世界卫生组织的诊断标准，美国54%的绝经后白人女性患有骨质减少，另有30%患有骨质疏松症。现有的骨折也是未来椎体骨折风险的强有力的独立预测因素，但也代表了疾病的一个较晚且较难治疗的阶段。
