VERTEBRAL DEFORMITY, BONE-MINERAL DENSITY, BACK PAIN AND HEIGHT LOSS IN UNSCREENED WOMEN OVER 50 YEARS

Bone mineral density (BMD) was measured in the lumbar spine using dual -energy X-ray absorptiometry in 222 unscreened women (aged 50-82 years ), and information on back pain and historic loss of standing height w as obtained at interview. Vertebral morphometry was performed on later al spinal radiographs. The shape of the vertebral body was quantified using appropriate vertebral shape indices (VSIs), and vertebral deform ities were identified using thresholds defined in terms of the means ( M) and standard deviations (SD) of these VSIs for the whole group. Sev erity of deformity was defined as either grade 1 (M+2SD < VSI < M+3SD) , grade 2 (M+3SD < VSI < M+4SD or grade 3 (VSI > M+4SD). Subjects with grade 1 vertebral deformities were older than subjects without such d eformities, but did not have a reduced age-related Z-score of BMD. Gra de 2 wedge and concave deformities were associated with a reduced age- related Z-score of BMD, suggesting that the aetiology of such deformit ies is closest to conventional concepts of 'osteoporotic fracture'. Gr ade 3 deformities were associated with neither increased age nor decre ased BMD. Stature decreased in these subjects with age. Subjects repor ting historic height loss had a higher mean number of wedge deformitie s. Subjects with back pain did not have a higher incidence of vertebra l deformity than subjects without, confirming that many deformities we re asymtomatic. Neither back pain nor historic loss of height were fou nd to be associated with low spinal BMD.