Abstract
In order to study vertebral fractures in various study populations, we earlier prepared a database of vertebral dimensions derived from spinal radiographs of 191 normal women seen regularly over 25 years. In this report we have expanded the range of measurements to include vertebral levels T3 to L5. We report means and standard deviations on anterior and posterior heights, on wedge shape and on heights relative to adjacent vertebrae. When one or both of the latter two quantities are ‘far’ below the mean, a vertebra is called deformed. We also describe a more flexible way of expressing damage using the number of deformed vertebrae, the degree of deformity of individual vertebrae, or the total damage to the entire spine. In assessing damage we use criteria for deformity adjusted to the limits detected by an experienced diagnostician, replacing an earlier approach based on 95% probability limits of normal variation. The normal women from whom these variations are ascertained are a low-prevalence group with respect to vertebral deformity, with prevalence of 2.8%. When the criteria developed from these women were applied to a moderate-prevalence group (37%) the model had a sensitivity of 97%, a specificity of 89% and an accuracy of 92% as regards the identification of subjects with damaged vertebrae. When used epidemiologically for a moderate-prevalence group the model has a known overestimation of 15%. The model is compared with other schemes for identifying vertebral deformities.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Davies KM, Recker RR, Heaney RP. Normal vertebral dimension and normal variation in serial measurement of vertebrae. J Bone Miner Res 1989;4:341–9.
Sauer P, Leidig G, Minne HW, et al. Spinal deformity index (SDI) versus other objective procedures of vertebral fracture identification in patients with osteoporosis: a comparative study. J Bone Miner Res 1991;6:227–38.
Heaney RP, Saville PD, Recker RR. Calcium absorption as a function of calcium intake. J Lab Clin Med 1975;85:881–890.
Heaney RP, Recker RR, Saville PD. Calcium balance and calcium requirements in middle-aged women. Am J Clin Nutr 1977;30:1603–11.
Heaney RP, Recker RR. Distribution of calcium absorption in middle-aged women. Am J Clin Nutr 1986;43:299–305.
Heaney RP, Avioli LV, Chesnut CH, III, et al. Osteoporotic bone fragility. JAMA 1989;261:2986–90.
Smith-Bindman R, Cummings SR, Steiger P, et al. A comparison of morphometric definitions of vertebral fracture. J Bone Miner Res 1991;6:25–34.
Eastell R, Cedel SL, Wahner HW, et al. Classification of vertebral fractures. J Bone Miner Res 1991;6:207–15.
Minne HW, Leidig G, Wuster C, et al. A newly developed spine deformity index (SDI) to quantitate vertebral crush fractures in patients with osteoporosis. Bone Miner 1988;3:335–49.
Hedlund LR, Gallagher JC. Vertebral morphometry in diagnosis of spinal osteoporosis. Bone Miner 1988;5:59–67.
Melton LJ III, Kan SH, Frye KM, et al. Epidemiology of vertebral fractures in women. Am J Epidemiol 1989;129:1000–11.
Sackett DL, Haynes RB, Tugwell P. Clinical epidemiology: a basic science for clinical medicine. Boston: Little, Brown, 1985:152–3.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Davies, K.M., Recker, R.R. & Heaney, R.P. Revisable criteria for vertebral deformity. Osteoporosis Int 3, 265–270 (1993). https://doi.org/10.1007/BF01623831
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01623831