Number and type of vertebral deformities: Epidemiological characteristics and relation to back pain and height loss
Number and type of vertebral deformities: Epidemiological characteristics and relation to back pain and height loss
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DOI：
10.1007/s001980050138
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发表时间：
1999-01-01
影响因子：
4
通讯作者：
O'Neill, TW
中科院分区：
文献类型：
--
作者：
Ismail, AA;Cooper, C;O'Neill, TW
脊椎畸形是骨质疏松症的典型特征。通常描述三种类型的脊椎畸形：挤压畸形、楔形畸形和双凹畸形。然而，关于个体畸形类型的描述性流行病学的数据很少，其潜在发病机制和临床影响的差异仍不确定。本研究的目的是比较三种脊椎畸形的流行病学特征，并探讨畸形的数量和类型与腰痛和身高下降的关系。50岁及以上的男性和女性的年龄分层随机样本是从30个欧洲中心的人口登记中招募的(EVOS研究)。受试者被邀请参加面试者管理的问卷和脊柱侧位X线片。使用McCloskey-Kanis算法确定椎体畸形的存在、类型和数量。共研究了13562名男性和女性；男性的平均年龄为63.3岁(SD 8.5)，女性为63.8岁(SD 8.5岁)。楔形畸形、挤压畸形和双凹畸形的发生率随年龄、性别和椎体水平的不同而不同。楔形畸形是最常见的畸形，在男性和女性中，楔形畸形倾向于聚集在胸中和胸腰椎区域。对于挤压畸形和较小程度的双凹畸形，这些部位也有类似的倾向，尽管这比楔形畸形要小得多。在男女中，双凹畸形在腰椎的发生率高于胸椎，而且与其他畸形类型不同，它在较低的腰椎水平上的发生率并没有下降。所有三种类型的脊椎畸形的患病率都随着年龄的增长而增加，在女性中更为明显。年龄对不同畸形类型的影响无显著差异。所有类型的畸形都与身高下降有关，这在患有挤压畸形的人中最大。背部疼痛也与所有类型的畸形有关。总体而言，这些结果并不表明这三种畸形类型在病理生理学上存在重要差异。生物力学因素似乎是决定它们在脊柱中分布的重要因素。所有畸形类型都与不良后果有关，尽管挤压畸形比其他畸形类型表现出更大的身高损失。
Vertebral deformity is the classical hallmark of osteoporosis. Three types of vertebral deformity are usually described: crush, wedge and biconcave deformities. However, there are few data concerning the descriptive epidemiology of the individual deformity types, and differences in their underlying pathogenesis and clinical impact remain uncertain. The aim of this study was to compare the epidemiological characteristics of the three types of vertebral deformity and to explore the relationships of the number and type of deformity with back pain and height loss. Age-stratified random samples of men and women aged 50 years and over were recruited from population registers in 30 European centers (EVOS study). Subjects were invited to attend for an interviewer-administered questionnaire and lateral spinal radiographs. The presence, type and number of vertebral deformities was determined using the McCloskey-Kanis algorithm. A total of 13 562 men and women were studied; mean age in men was 63.3 years (SD 8.5), and in women 63.8 years (SD 8.5 years). There was evidence of variation in the occurrence of wedge, crush and biconcave deformity by age, sex and vertebral level. Wedge deformities were the most frequent deformity and tended to cluster at the mid-thoracic and thoracolumbar regions of the spine in both men and women. Similar predilection for these sites was observed for crush and to a lesser extent biconcave deformities though this was much less marked than for wedge deformities. In both sexes the frequency of biconcave deformities was higher in the lumbar than the thoracic spine and unlike the other deformity types it did not decline in frequency at lower lumbar vertebral levels. The prevalence of all three types of vertebral deformity increased with age and was more marked in women. There were no important differences in the effect of age on the different deformity types. All types of deformity were associated with height loss, which was greatest for individuals with crush deformity. Back pain was also associated with all types of deformity. Overall, these results do not suggest important differences in pathophysiology between the three deformity types. Biomechanical factors appear to be important in determining their distribution with the spine. All deformity types are linked with adverse outcomes, though crush deformities showed greater height loss than the other deformity types.