Vertebral fractures in osteoporosis -: A new method for clinical assessment
Vertebral fractures in osteoporosis -: A new method for clinical assessment
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DOI：
10.1385/jcd:3:3:281
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发表时间：
2000-09-01
影响因子：
2.5
通讯作者：
Shepherd, JA
中科院分区：
文献类型：
--
作者：
Genant, HK;Li, J;Shepherd, JA
椎体骨折是骨质疏松症最常见的后果，也是后续骨折的重要危险因素。骨密度（BMD）降低和椎体骨折的患者未来发生骨折的风险显著增加，表明骨折评估和骨密度联合应用于风险评估具有很大的潜力。然而，尽管骨折的重要性已经确立，但在临床评估骨质疏松症风险患者时，通常不进行椎体评估。x线片是骨折评估的公认标准，但由于各种实际原因，包括成本、辐射剂量和缺乏办公室放射设备，很少在骨质疏松症评估中获得。骨折的临床评估是困难的，因为大多数是无症状的。因此，骨质疏松性骨折的这一危险因素常常被忽视。通过先进的扇束双x线吸收仪（DXA）系统获得的高分辨率脊柱侧位图像，为评估椎体骨折提供了一种实用的、低辐射剂量的护理方法，并有可能解决这一重要的临床需求。在本文中，我们回顾了椎体骨折的重要性和评估方法。我们还回顾了支持使用扇束DXA系统对侧脊柱图像进行视觉评估的可行性的临床数据，并讨论了这种新方法对临床患者评估的潜在积极影响。
Vertebral fractures are the most common consequence of osteoporosis and are an important risk factor for subsequent fractures. Patients with reduced bone mineral density (BMD) and vertebral fractures have significantly increased risk for future fractures, indicating great potential for the combined use of fracture assessment and BMD in risk evaluation. Despite the established importance of fractures, however, vertebral assessment is not typically performed in the clinical evaluation of patients at risk for osteoporosis. Radiographs are the accepted standard for assessment of fractures but are rarely obtained in osteoporosis assessment for a variety of practical reasons, including cost, radiation dose, and the lack of office-based radiologic facilities. Clinical assessment of Fractures is difficult because most are asymptomatic. Consequently, this strong risk factor for osteoporotic fractures is often overlooked. High-resolution lateral spine images, obtained on advanced fan-beam dual X-ray absorptiometry (DXA) systems, provide a practical, low-radiation dose, point-of-care methodology for assessment of vertebral fractures, and have the potential to address this important clinical need. In this article, we review the importance of vertebral fractures and the methods of assessing them. We also review clinical data supporting the feasibility of visual evaluation of lateral spine images obtained using a fan-beam DXA system, and discuss the potential positive impact of this new methodology on clinical patient evaluation.