Elsevier

Bone

Volume 14, Supplement 1, 1993, Pages 89-97
Bone

The epidemiology of vertebral fractures

https://doi.org/10.1016/8756-3282(93)90358-HGet rights and content

Abstract

Vertebral fractures are recognised as a hallmark of osteoporosis, yet little is known of their epidemiology. This deficiency limits accurate characterisation of the public health importance of osteoporosis. Assessment of the impact of vertebral fractures has been hampered by the absence of formal criteria for identifying fractures on a thoracolumbar radiograph. Initial methods relying upon subjective radiological assessments have given way to morphometric measurements of vertebral heights, with deformities defined according to various algorithms. These methods have been used in a series of studies performed in Rochester, MN, to determine the incidence, outcome, and time trends of vertebral deformities. The results suggest a prevalence rate of vertebral deformity of 25.3 per-100 Rochester women aged 50 years and over (95% CI, 22.3–28.2), with an estimated incidence of 17.8 per 1,000 person-years. The incidence of clinically diagnosed vertebral fractures among women in the same population was 5.3 per 1,000 person-years, suggesting that around 30% of such deformities in women receive clinical attention. Morphometric measurement on the radiographs of women with clinically diagnosed fractures revealed that 80% had grade 2 (>4 SD) deformities. Comparable data on the occurrence and health impact of vertebral deformities throughout Europe are urgently required. The European Vertebral Osteoporosis Study (EVOS) is a multicentre epidemiological study that aims to address this issue. It is designed as a radiographic prevalence study in 34 European centres. Age-stratified samples of 300 men and 300 women aged 50 years and over are selected from population registers in each centre, and undergo standardised thoracolumbar radiography, anthropometry, and a structured interview on current and past risk factors for osteoporosis. Data on the design of the study, und preliminary results on the prevalence of vertebral deformities and individual risk factors in selected centres will be presented elsewhere.

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