Flattening of sagittal spinal curvature as a predictor of vertebral fracture
Flattening of sagittal spinal curvature as a predictor of vertebral fracture
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DOI：
10.1007/s00198-007-0432-y
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发表时间：
2008-01-01
影响因子：
4
通讯作者：
Matsuno, T.
中科院分区：
文献类型：
--
作者：
Kobayashi, T.;Takeda, N.;Matsuno, T.
在一项100名成年志愿者的12年前瞻性研究中，分析了突发椎骨骨折的潜在预测因素。脊柱矢状弯曲度降低和既存骨折被确定为独立的预测因素。脊椎骨折的风险增加到8.6倍，1 SD减少在两个胸椎和腰椎curves.Introduction生理脊柱弯曲作为减震器：然而，它还没有被证明是否减少脊柱弯曲是脊椎骨折的风险。这项前瞻性研究的目的是评估脊柱矢状弯曲的程度和椎骨fractures.Methods的发病率之间的关系，100个社区为基础的志愿者年龄在50岁以上的放射学随访至少10年。志愿者在直立位的整个脊柱X线片用于评估矢状脊柱弯曲，骨质疏松症的等级，和事件verticalfractions.Results平均基线年龄为61.9岁，平均随访期为12.0年。在多变量分析中，先前存在的椎骨骨折（相对风险[RR] 3.70，95%置信区间[CI] 1.22-11.20）和胸椎或腰椎弯曲度降低1-SD（RR 3.06，95% CI 1.04-9.00）是独立的预测因素。胸腰椎生理曲度每减少1个标准差，骨折危险性增加（RR 8.64，95% CI 1.39-53.78）。结论胸腰椎生理曲度减少可使骨折危险性增加8倍以上。应强调评估脊柱矢状面对线的重要性，因为它可能提示首次椎体骨折的风险，这是后续骨折的另一个强有力的预测因素。
In a 12-year prospective study of 100 adult volunteers, incident vertebral fractures were analyzed for potential predictors. Decreased sagittal spinal curvature and pre-existing fractures were identified as independent predictors. The risk of vertebral fracture increased to 8.6-fold with a 1 SD decrease in both thoracic and lumbar curves.Introduction Physiological spinal curvature acts as a shock absorber: however, it has not been demonstrated whether reduced spinal curvature is a risk of vertebral fracture. The aim of this prospective study is to assess the relationship between the extent of sagittal spinal curvature and incidence of vertebral fractures.Methods One hundred community-based volunteers aged 50+ years were followed radiologically for at least 10 years. Entire spine radiograms of volunteers in erect position were used for evaluating sagittal spinal curvatures, grade of osteoporosis, and incident vertebral fractures.Results Mean baseline age was 61.9 years and mean follow-up period was 12.0 years. In multivariate analysis, preexisting vertebral fracture (relative risk [RR] 3.70, 95% confidence interval [CI] 1.22-11.20), and a decrease in either thoracic or lumbar curvature by 1-SD (RR 3.06, 95% CI 1.04-9.00) were independent predictors. The fracture risk even increased in the presence of a 1-SD decrease in both thoracic and lumbar curvature (RR 8.64, 95% CI 1.39-53.78).Conclusions Reduction of physiological curvatures in both thoracic and lumbar spine led to the increased risk of vertebral fracture by more than eightfold. The importance of evaluating sagittal spinal alignment should be emphasized, because it might indicate the risk of the first vertebral fracture, which is another strong predictor of subsequent fractures.