Huang C, Ross P D, Wasnich R D
Hawaii Osteoporosis Center, Honolulu, USA.
Arch Intern Med. 1996 Nov 25;156(21):2469-75.
A better understanding of the impact of vertebral fractures on physical functioning would help clinicians gauge the potential benefits of identifying patients at high risk and prevent vertebral fractures due to osteoporosis.
We explored the associations of vertebral fractures and other potential predictors with physical impairment and health care utilization based on the data collected from 569 postmenopausal Japanese American participants of the Hawaii Osteoporosis Study, aged from 55 to 93 years. A major advantage of this study is the availability of serial spine radiographs for all participants. All vertebral fractures could be identified and the fracture dates estimated.
Poor physical functioning was related to increases in number of recent vertebral fractures, age, body mass index, and number of other painful joints. Recent vertebral fractures had a strong impact on bending- and walking-related activities. For each recent vertebral fracture, the odds of impairment increased about 2 times and the odds of a physician visit for back pain increased 3.6 times. The number of recent vertebral fractures was also a significant predictor of poor performance in functional reach and walking speed tests. The effects of vertebral fractures on physical functioning may persist for several years.
Recent vertebral fractures may lead to long-term poor physical functioning. Clinicians should take appropriate measures to identify those at risk, to prevent progression of osteoporosis, and to limit associated disability.
更好地了解椎体骨折对身体功能的影响，将有助于临床医生评估识别高危患者的潜在益处，并预防因骨质疏松症导致的椎体骨折。
我们基于从569名年龄在55至93岁之间的绝经后日裔美国夏威夷骨质疏松症研究参与者收集的数据，探讨了椎体骨折及其他潜在预测因素与身体损伤和医疗保健利用之间的关联。这项研究的一个主要优势是所有参与者都可获得系列脊柱X光片。所有椎体骨折均可被识别并估算骨折日期。
身体功能较差与近期椎体骨折数量增加、年龄、体重指数以及其他疼痛关节数量有关。近期椎体骨折对弯腰和行走相关活动有强烈影响。每发生一次近期椎体骨折，损伤几率增加约2倍，因背痛就医的几率增加3.6倍。近期椎体骨折数量也是功能伸展和步行速度测试表现不佳的重要预测因素。椎体骨折对身体功能的影响可能会持续数年。
近期椎体骨折可能导致长期身体功能不佳。临床医生应采取适当措施识别那些有风险的患者，预防骨质疏松症进展，并限制相关残疾。
