Detection of prefracture spinal osteoporosis using bone mineral absorptiometry

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
P D RossJ M Vogel

Abstract

Bone mineral measurements have been criticized for their inability to clearly distinguish fracture and "nonfracture" populations. However, this failure is not unexpected, since some individuals in the "nonfracture" group have low bone mass and are at increased risk but have not yet experienced fractures. Although standard radiographs are not sensitive indicators of vertebral demineralization, they do identify some of the "prefracture" osteoporotic subpopulation within the nonfracture group. Prospective follow-up of 536 Japanese-American women demonstrated that 14 new spine fractures occurred in the prefracture osteoporosis group, whereas none occurred in the nonosteoporotic group (p less than or equal to 0.03). However, bone mineral content (BMC) measurements using photon absorptiometry were much more accurate than radiographs as indicators of spine fracture risk. BMC values were somewhat higher in the prefracture group than in those with existing fractures, but values for both groups were significantly lower than in nonosteoporotic patients even after adjusting for age, height, and weight (p less than 0.0001). The magnitude of the difference was proportional to the trabecular bone content of the measurement site; the differenc...Continue Reading

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