Correlates of kyphosis in older women
Correlates of kyphosis in older women
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DOI：
10.1111/j.1532-5415.1997.tb01470.x
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发表时间：
1997-06-01
影响因子：
6.3
通讯作者：
Cummings, SR
中科院分区：
文献类型：
--
作者：
Ensrud, KE;Black, DM;Cummings, SR
目的：为了确定脊柱后凸（胸椎前曲程度）和脊柱骨质疏松的测量设计：一项横断面研究。地点：美国的11个临床中心。参与者：共有6439名年龄在55-80岁的社区居住的骨质疏松妇女参加了骨折干预试验（FIT），这是一项阿仑膦酸钠的多中心临床试验。使用Debreuner椎体后凸测量仪在基线时测量胸椎曲率。身高损失是通过从25岁时自我报告的身高中减去用哈彭登测距仪测量的当前身高来确定的。通过形态测量和侧位胸椎和腰椎X线片的半定量阅读来确定椎体骨折，并通过问卷调查来评估慢性背痛和与背部相关的残疾。结果：在调整年龄后，后凸畸形增加15度与身高损失超过4 cm相关（OR，1.88; 95% CI，1.79-2.03）和椎体骨折（OR，1.57; 95% CI，1.46-1.69）。脊柱后凸与胸椎骨折的相关性比与腰椎骨折的相关性更强，并且脊柱后凸在多发性胸椎楔形骨折的女性中最为突出。脊柱后凸还与上背痛（OR每增加15度，1.62; 95% CI 1.47-1.79）和中背痛（OR每增加15度，1.24; 95% CI 1.12-1.36）相关，但与下背痛无关（OR每增加15度，0.98; 95% CI 0.90-1.05）。脊柱后凸程度更大的女性报告背部相关残疾的可能性仅略高（OR每升高15度，1.18; 95% CI 1.03-1.35）和健康状况较差（每增加15度的OR，1.19; 95% CI 1.03-1.37）。脊柱后凸程度较大的老年妇女可能有脊柱骨质疏松症的其他表现，如身高下降和胸椎骨折，并遭受慢性上背部和中背部疼痛。测量脊柱后凸畸形可能有助于评估脊柱骨质疏松的严重程度。
OBJECTIVE: To determine the association between kyphosis (degree of forward curvature of the thoracic spine) and measures of spinal osteoporosis (height loss and vertebral fractures) and chronic back pain and disability in older women.DESIGN: A cross-sectional study.SETTING: Eleven clinical centers in the United States.PARTICIPANTS: A total of 6439 community-dwelling osteoporotic women aged 55-80 enrolled in the Fracture Intervention Trial (FIT), a multicenter clinical trial of alendronate.MEASUREMENTS: Thoracic curvature was measured at baseline using a Debreuner Kyphometer. Height loss was determined by subtracting current height measured with a Harpenden stadiometer from self-reported height at age 25. Vertebral fractures were defined by morphometry and semiquantitative reading of lateral thoracic and lumbar spine radiographs, and chronic back pain and back-related disability were assessed by questionnaire.RESULTS: After adjustment for age, a 15 degrees increase in kyphosis was associated with losing more than 4 cm of height (OR, 1.88; 95% CI, 1.79-2.03) and having a vertebral fracture (OR, 1.57; 95% CI, 1.46-1.69). Kyphosis was more strongly related to thoracic fractures than to lumbar fractures, and kyphosis was most prominent in women with multiple thoracic wedge fractures. Kyphosis was also associated with upper back pain (OR per 15 degrees increase, 1.62; 95% CI 1.47-1.79) and middle back pain (OR per 15 degrees increase, 1.24; 95% CI 1.12-1.36), but it was not related to lower back pain (OR per 15 degrees increase, 0.98; 95% CI 0.90-1.05). Women with greater degrees of kyphosis were only slightly more likely to report back- related disability (OR per 15 degrees increase, 1.18; 95% CI 1.03-1.35) and poorer health status (OR per 15 degrees increase, 1.19; 95% CI 1.03-1.37).CONCLUSIONS: Older women with greater degrees of kyphosis are likely to have other manifestations of spinal osteoporosis such as height loss and thoracic fractures and to suffer chronic upper and middle back pain. Measurement of kyphosis may be useful in assessing the severity of spinal osteoporosis.