Brian C Lentle, Claudie Berger, Jacques P Brown, Linda Probyn, Lisa Langsetmo, Ian Hammond, Jeff Hu, William D Leslie, Jerilynn C Prior, David A Hanley, Jonathan D Adachi, Robert G Josse, Angela M Cheung, Stephanie M Kaiser, Tanveer Towheed, Christopher S Kovacs, Andy Kin On Wong, David Goltzman
{"title":"椎体骨折:哪个放射学标准与骨质疏松症的临床病程更相关?","authors":"Brian C Lentle, Claudie Berger, Jacques P Brown, Linda Probyn, Lisa Langsetmo, Ian Hammond, Jeff Hu, William D Leslie, Jerilynn C Prior, David A Hanley, Jonathan D Adachi, Robert G Josse, Angela M Cheung, Stephanie M Kaiser, Tanveer Towheed, Christopher S Kovacs, Andy Kin On Wong, David Goltzman","doi":"10.1177/0846537120943529","DOIUrl":null,"url":null,"abstract":"<p><strong>Study purpose: </strong>Morphometric methods categorize potential osteoporotic vertebral fractures (OVF) on the basis of loss of vertebral height. A particular example is the widely used semiquantitative morphometric tool proposed by Genant (GSQ). A newer morphologic algorithm-based qualitative (mABQ) tool focuses on vertebral end-plate damage in recognizing OVF. We used data from both sexes in the Canadian Multicentre Osteoporosis Study (CaMos) to compare the 2 methods in identifying OVF at baseline and during 10 years of follow-up.</p><p><strong>Materials and methods: </strong>We obtained lateral thoracic and lumbar spinal radiographs (T4-L4) 3 times, at 5-year intervals, in 828 participants of the population-based CaMos. Logistic regressions were used to study the association of 10-year changes in bone mineral density (BMD) with incident fractures.</p><p><strong>Results: </strong>At baseline, 161 participants had grade 1 and 32 had grade 2 GSQ OVF; over the next 10 years, only 9 of these participants had sustained incident GSQ OVF. Contrastingly, 21 participants at baseline had grade 1 and 48 grade 2 mABQ events; over the next 10 years, 79 subjects experienced incident grade 1 or grade 2 mABQ events. Thus, incident grades 1 and 2 morphologic fractures were 8 times more common than morphometric deformities alone. Each 10-year decrease of 0.01 g/cm<sup>2</sup> in total hip BMD was associated with a 4.1% (95% CI: 0.7-7.3) higher odds of having an incident vertebral fracture.</p><p><strong>Conclusions: </strong>This analysis further suggests that morphometric deformities and morphologic fractures constitute distinct entities; morphologic fractures conform more closely to the expected epidemiology of OVF.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"150-158"},"PeriodicalIF":0.0000,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120943529","citationCount":"6","resultStr":"{\"title\":\"Vertebral Fractures: Which Radiological Criteria Are Better Associated With the Clinical Course of Osteoporosis?\",\"authors\":\"Brian C Lentle, Claudie Berger, Jacques P Brown, Linda Probyn, Lisa Langsetmo, Ian Hammond, Jeff Hu, William D Leslie, Jerilynn C Prior, David A Hanley, Jonathan D Adachi, Robert G Josse, Angela M Cheung, Stephanie M Kaiser, Tanveer Towheed, Christopher S Kovacs, Andy Kin On Wong, David Goltzman\",\"doi\":\"10.1177/0846537120943529\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study purpose: </strong>Morphometric methods categorize potential osteoporotic vertebral fractures (OVF) on the basis of loss of vertebral height. A particular example is the widely used semiquantitative morphometric tool proposed by Genant (GSQ). A newer morphologic algorithm-based qualitative (mABQ) tool focuses on vertebral end-plate damage in recognizing OVF. We used data from both sexes in the Canadian Multicentre Osteoporosis Study (CaMos) to compare the 2 methods in identifying OVF at baseline and during 10 years of follow-up.</p><p><strong>Materials and methods: </strong>We obtained lateral thoracic and lumbar spinal radiographs (T4-L4) 3 times, at 5-year intervals, in 828 participants of the population-based CaMos. Logistic regressions were used to study the association of 10-year changes in bone mineral density (BMD) with incident fractures.</p><p><strong>Results: </strong>At baseline, 161 participants had grade 1 and 32 had grade 2 GSQ OVF; over the next 10 years, only 9 of these participants had sustained incident GSQ OVF. Contrastingly, 21 participants at baseline had grade 1 and 48 grade 2 mABQ events; over the next 10 years, 79 subjects experienced incident grade 1 or grade 2 mABQ events. Thus, incident grades 1 and 2 morphologic fractures were 8 times more common than morphometric deformities alone. Each 10-year decrease of 0.01 g/cm<sup>2</sup> in total hip BMD was associated with a 4.1% (95% CI: 0.7-7.3) higher odds of having an incident vertebral fracture.</p><p><strong>Conclusions: </strong>This analysis further suggests that morphometric deformities and morphologic fractures constitute distinct entities; morphologic fractures conform more closely to the expected epidemiology of OVF.</p>\",\"PeriodicalId\":444006,\"journal\":{\"name\":\"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes\",\"volume\":\" \",\"pages\":\"150-158\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1177/0846537120943529\",\"citationCount\":\"6\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/0846537120943529\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/8/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/0846537120943529","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/8/5 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Vertebral Fractures: Which Radiological Criteria Are Better Associated With the Clinical Course of Osteoporosis?
Study purpose: Morphometric methods categorize potential osteoporotic vertebral fractures (OVF) on the basis of loss of vertebral height. A particular example is the widely used semiquantitative morphometric tool proposed by Genant (GSQ). A newer morphologic algorithm-based qualitative (mABQ) tool focuses on vertebral end-plate damage in recognizing OVF. We used data from both sexes in the Canadian Multicentre Osteoporosis Study (CaMos) to compare the 2 methods in identifying OVF at baseline and during 10 years of follow-up.
Materials and methods: We obtained lateral thoracic and lumbar spinal radiographs (T4-L4) 3 times, at 5-year intervals, in 828 participants of the population-based CaMos. Logistic regressions were used to study the association of 10-year changes in bone mineral density (BMD) with incident fractures.
Results: At baseline, 161 participants had grade 1 and 32 had grade 2 GSQ OVF; over the next 10 years, only 9 of these participants had sustained incident GSQ OVF. Contrastingly, 21 participants at baseline had grade 1 and 48 grade 2 mABQ events; over the next 10 years, 79 subjects experienced incident grade 1 or grade 2 mABQ events. Thus, incident grades 1 and 2 morphologic fractures were 8 times more common than morphometric deformities alone. Each 10-year decrease of 0.01 g/cm2 in total hip BMD was associated with a 4.1% (95% CI: 0.7-7.3) higher odds of having an incident vertebral fracture.
Conclusions: This analysis further suggests that morphometric deformities and morphologic fractures constitute distinct entities; morphologic fractures conform more closely to the expected epidemiology of OVF.