Determinants of the size of incident vertebral deformities in European men and women in the sixth to ninth decades of age: The European Prospective Osteoporosis Study (EPOS)

J. Reeve, M. Lunt, D. Felsenberg, A. J. Silman, C. Scheidt-Nave, G. Poór, C. Gennari, K. Weber, R. Lorenc, P. Masaryk, J. B. Cannata, J. Dequeker, D. M. Reid, H. A P Pols, L. I. Benevolenskaya, J. J. Stepan, T. Miazgowski, A. Bhalla, J. Bruges Armas, R. EastellA. Lopes-Vaz, G. Lyritis, I. Jajic, A. D. Woolf, D. Banzer, W. Reisinger, C. J. Todd, B. Felsch, S. Havelka, K. Hoszowski, J. Janott, O. Johnell, H. H. Raspe, O. B. Yershova, J. A. Kanis, G. Armbrecht, J. D. Finn, W. Gowin, T. W. O'Neill

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

More severe vertebral fractures have more personal impact. In the European Prospective Osteoporosis Study, more severe vertebral collapse was predictable from prior fracture characteristics. Subjects with bi-concave or crush fractures at baseline had a 2-fold increase in incident fracture size and thus increased risk of a disabling future fracture. Introduction: According to Euler's buckling theory, loss of horizontal trabeculae in vertebrae increases the risk of fracture and suggests that the extent of vertebral collapse will be increased in proportion. We tested the hypothesis that the characteristics of a baseline deformity would influence the size of a subsequent deformity. Methods: In 207 subjects participating in the European Prospective Osteoporosis Study who suffered an incident spine fracture in a previously normal vertebra, we estimated loss of volume (fracture size) from plane film images of all vertebral bodies that were classified as having a new fracture. The sum of the three vertebral heights (anterior, mid-body, and posterior) obtained at follow-up was subtracted from the sum of the same measures at baseline. Each of the summed height loss for vertebrae with a McCloskey-Kanis deformity on the second film was expressed as a percentage. Results and Conclusions: In univariate models, the numbers of baseline deformities and the clinical category of the most severe baseline deformity were each significantly associated with the size of the most severe incident fracture and with the cumulated sum of all vertebral height losses. In multivariate modeling, age and the clinical category of the baseline deformity (crush > bi-concave > uni-concave > wedge) were the strongest determinants of both more severe and cumulative height loss. Baseline biconcave and crush fractures were associated at follow-up with new fractures that were approximately twice as large as those seen with other types of deformity or who previously had undeformed spines. In conclusion, the characteristics of a baseline vertebral deformity determines statistically the magnitude of vertebral body volume lost when a subsequent fracture occurs. Because severity of fracture and number of fractures are determinants of impact, the results should improve prediction of the future personal impact of osteoporosis once a baseline prevalent deformity has been identified.

Original languageEnglish
Pages (from-to)1664-1673
Number of pages10
JournalJournal of Bone and Mineral Research
Volume18
Issue number9
DOIs
Publication statusPublished - Sep 1 2003

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Osteoporosis
Spine
Prospective Studies
Motion Pictures
Crush Injuries

Keywords

  • Cohort study
  • Fracture risk
  • Osteoporosis
  • Radiological morphometry
  • Vertebral fractures

ASJC Scopus subject areas

  • Surgery

Cite this

Determinants of the size of incident vertebral deformities in European men and women in the sixth to ninth decades of age : The European Prospective Osteoporosis Study (EPOS). / Reeve, J.; Lunt, M.; Felsenberg, D.; Silman, A. J.; Scheidt-Nave, C.; Poór, G.; Gennari, C.; Weber, K.; Lorenc, R.; Masaryk, P.; Cannata, J. B.; Dequeker, J.; Reid, D. M.; Pols, H. A P; Benevolenskaya, L. I.; Stepan, J. J.; Miazgowski, T.; Bhalla, A.; Armas, J. Bruges; Eastell, R.; Lopes-Vaz, A.; Lyritis, G.; Jajic, I.; Woolf, A. D.; Banzer, D.; Reisinger, W.; Todd, C. J.; Felsch, B.; Havelka, S.; Hoszowski, K.; Janott, J.; Johnell, O.; Raspe, H. H.; Yershova, O. B.; Kanis, J. A.; Armbrecht, G.; Finn, J. D.; Gowin, W.; O'Neill, T. W.

In: Journal of Bone and Mineral Research, Vol. 18, No. 9, 01.09.2003, p. 1664-1673.

Research output: Contribution to journalArticle

Reeve, J, Lunt, M, Felsenberg, D, Silman, AJ, Scheidt-Nave, C, Poór, G, Gennari, C, Weber, K, Lorenc, R, Masaryk, P, Cannata, JB, Dequeker, J, Reid, DM, Pols, HAP, Benevolenskaya, LI, Stepan, JJ, Miazgowski, T, Bhalla, A, Armas, JB, Eastell, R, Lopes-Vaz, A, Lyritis, G, Jajic, I, Woolf, AD, Banzer, D, Reisinger, W, Todd, CJ, Felsch, B, Havelka, S, Hoszowski, K, Janott, J, Johnell, O, Raspe, HH, Yershova, OB, Kanis, JA, Armbrecht, G, Finn, JD, Gowin, W & O'Neill, TW 2003, 'Determinants of the size of incident vertebral deformities in European men and women in the sixth to ninth decades of age: The European Prospective Osteoporosis Study (EPOS)', Journal of Bone and Mineral Research, vol. 18, no. 9, pp. 1664-1673. https://doi.org/10.1359/jbmr.2003.18.9.1664
Reeve, J. ; Lunt, M. ; Felsenberg, D. ; Silman, A. J. ; Scheidt-Nave, C. ; Poór, G. ; Gennari, C. ; Weber, K. ; Lorenc, R. ; Masaryk, P. ; Cannata, J. B. ; Dequeker, J. ; Reid, D. M. ; Pols, H. A P ; Benevolenskaya, L. I. ; Stepan, J. J. ; Miazgowski, T. ; Bhalla, A. ; Armas, J. Bruges ; Eastell, R. ; Lopes-Vaz, A. ; Lyritis, G. ; Jajic, I. ; Woolf, A. D. ; Banzer, D. ; Reisinger, W. ; Todd, C. J. ; Felsch, B. ; Havelka, S. ; Hoszowski, K. ; Janott, J. ; Johnell, O. ; Raspe, H. H. ; Yershova, O. B. ; Kanis, J. A. ; Armbrecht, G. ; Finn, J. D. ; Gowin, W. ; O'Neill, T. W. / Determinants of the size of incident vertebral deformities in European men and women in the sixth to ninth decades of age : The European Prospective Osteoporosis Study (EPOS). In: Journal of Bone and Mineral Research. 2003 ; Vol. 18, No. 9. pp. 1664-1673.
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abstract = "More severe vertebral fractures have more personal impact. In the European Prospective Osteoporosis Study, more severe vertebral collapse was predictable from prior fracture characteristics. Subjects with bi-concave or crush fractures at baseline had a 2-fold increase in incident fracture size and thus increased risk of a disabling future fracture. Introduction: According to Euler's buckling theory, loss of horizontal trabeculae in vertebrae increases the risk of fracture and suggests that the extent of vertebral collapse will be increased in proportion. We tested the hypothesis that the characteristics of a baseline deformity would influence the size of a subsequent deformity. Methods: In 207 subjects participating in the European Prospective Osteoporosis Study who suffered an incident spine fracture in a previously normal vertebra, we estimated loss of volume (fracture size) from plane film images of all vertebral bodies that were classified as having a new fracture. The sum of the three vertebral heights (anterior, mid-body, and posterior) obtained at follow-up was subtracted from the sum of the same measures at baseline. Each of the summed height loss for vertebrae with a McCloskey-Kanis deformity on the second film was expressed as a percentage. Results and Conclusions: In univariate models, the numbers of baseline deformities and the clinical category of the most severe baseline deformity were each significantly associated with the size of the most severe incident fracture and with the cumulated sum of all vertebral height losses. In multivariate modeling, age and the clinical category of the baseline deformity (crush > bi-concave > uni-concave > wedge) were the strongest determinants of both more severe and cumulative height loss. Baseline biconcave and crush fractures were associated at follow-up with new fractures that were approximately twice as large as those seen with other types of deformity or who previously had undeformed spines. In conclusion, the characteristics of a baseline vertebral deformity determines statistically the magnitude of vertebral body volume lost when a subsequent fracture occurs. Because severity of fracture and number of fractures are determinants of impact, the results should improve prediction of the future personal impact of osteoporosis once a baseline prevalent deformity has been identified.",
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TY - JOUR

T1 - Determinants of the size of incident vertebral deformities in European men and women in the sixth to ninth decades of age

T2 - The European Prospective Osteoporosis Study (EPOS)

AU - Reeve, J.

AU - Lunt, M.

AU - Felsenberg, D.

AU - Silman, A. J.

AU - Scheidt-Nave, C.

AU - Poór, G.

AU - Gennari, C.

AU - Weber, K.

AU - Lorenc, R.

AU - Masaryk, P.

AU - Cannata, J. B.

AU - Dequeker, J.

AU - Reid, D. M.

AU - Pols, H. A P

AU - Benevolenskaya, L. I.

AU - Stepan, J. J.

AU - Miazgowski, T.

AU - Bhalla, A.

AU - Armas, J. Bruges

AU - Eastell, R.

AU - Lopes-Vaz, A.

AU - Lyritis, G.

AU - Jajic, I.

AU - Woolf, A. D.

AU - Banzer, D.

AU - Reisinger, W.

AU - Todd, C. J.

AU - Felsch, B.

AU - Havelka, S.

AU - Hoszowski, K.

AU - Janott, J.

AU - Johnell, O.

AU - Raspe, H. H.

AU - Yershova, O. B.

AU - Kanis, J. A.

AU - Armbrecht, G.

AU - Finn, J. D.

AU - Gowin, W.

AU - O'Neill, T. W.

PY - 2003/9/1

Y1 - 2003/9/1

N2 - More severe vertebral fractures have more personal impact. In the European Prospective Osteoporosis Study, more severe vertebral collapse was predictable from prior fracture characteristics. Subjects with bi-concave or crush fractures at baseline had a 2-fold increase in incident fracture size and thus increased risk of a disabling future fracture. Introduction: According to Euler's buckling theory, loss of horizontal trabeculae in vertebrae increases the risk of fracture and suggests that the extent of vertebral collapse will be increased in proportion. We tested the hypothesis that the characteristics of a baseline deformity would influence the size of a subsequent deformity. Methods: In 207 subjects participating in the European Prospective Osteoporosis Study who suffered an incident spine fracture in a previously normal vertebra, we estimated loss of volume (fracture size) from plane film images of all vertebral bodies that were classified as having a new fracture. The sum of the three vertebral heights (anterior, mid-body, and posterior) obtained at follow-up was subtracted from the sum of the same measures at baseline. Each of the summed height loss for vertebrae with a McCloskey-Kanis deformity on the second film was expressed as a percentage. Results and Conclusions: In univariate models, the numbers of baseline deformities and the clinical category of the most severe baseline deformity were each significantly associated with the size of the most severe incident fracture and with the cumulated sum of all vertebral height losses. In multivariate modeling, age and the clinical category of the baseline deformity (crush > bi-concave > uni-concave > wedge) were the strongest determinants of both more severe and cumulative height loss. Baseline biconcave and crush fractures were associated at follow-up with new fractures that were approximately twice as large as those seen with other types of deformity or who previously had undeformed spines. In conclusion, the characteristics of a baseline vertebral deformity determines statistically the magnitude of vertebral body volume lost when a subsequent fracture occurs. Because severity of fracture and number of fractures are determinants of impact, the results should improve prediction of the future personal impact of osteoporosis once a baseline prevalent deformity has been identified.

AB - More severe vertebral fractures have more personal impact. In the European Prospective Osteoporosis Study, more severe vertebral collapse was predictable from prior fracture characteristics. Subjects with bi-concave or crush fractures at baseline had a 2-fold increase in incident fracture size and thus increased risk of a disabling future fracture. Introduction: According to Euler's buckling theory, loss of horizontal trabeculae in vertebrae increases the risk of fracture and suggests that the extent of vertebral collapse will be increased in proportion. We tested the hypothesis that the characteristics of a baseline deformity would influence the size of a subsequent deformity. Methods: In 207 subjects participating in the European Prospective Osteoporosis Study who suffered an incident spine fracture in a previously normal vertebra, we estimated loss of volume (fracture size) from plane film images of all vertebral bodies that were classified as having a new fracture. The sum of the three vertebral heights (anterior, mid-body, and posterior) obtained at follow-up was subtracted from the sum of the same measures at baseline. Each of the summed height loss for vertebrae with a McCloskey-Kanis deformity on the second film was expressed as a percentage. Results and Conclusions: In univariate models, the numbers of baseline deformities and the clinical category of the most severe baseline deformity were each significantly associated with the size of the most severe incident fracture and with the cumulated sum of all vertebral height losses. In multivariate modeling, age and the clinical category of the baseline deformity (crush > bi-concave > uni-concave > wedge) were the strongest determinants of both more severe and cumulative height loss. Baseline biconcave and crush fractures were associated at follow-up with new fractures that were approximately twice as large as those seen with other types of deformity or who previously had undeformed spines. In conclusion, the characteristics of a baseline vertebral deformity determines statistically the magnitude of vertebral body volume lost when a subsequent fracture occurs. Because severity of fracture and number of fractures are determinants of impact, the results should improve prediction of the future personal impact of osteoporosis once a baseline prevalent deformity has been identified.

KW - Cohort study

KW - Fracture risk

KW - Osteoporosis

KW - Radiological morphometry

KW - Vertebral fractures

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