Vertebral Fractures Often Absent in Kyphosis

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Vertebral Fractures Often Absent in Kyphosis

NEW YORK (Reuters Health) May 03 - Kyphosis need not be a result of

osteoporotic vertebral fractures, according to Californian researchers. In

fact, degenerative disc disease appeared to be the most common underlying

feature of kyphosis in a study of ambulatory, white adults between 50 and 96

years old.

In the April issue of the Journal of Rheumatology, Dr.

Barrett-Connor of the University of California, San Diego in La Jolla, and

colleagues determined whether, as generally accepted, kyphosis is a clinical

sign of osteoporotic fractures.

Accordingly, the researchers evaluated data for community-dwelling adults

who had taken part in research clinic visits. In all, 114 of 533 men (20.6%)

and 188 of 854 women (22.0%) had one or more thoracic vertebral fracture.

More widespread was degenerative disc disease, which was seen in 45.4% of

men and 56.7% of women. This, write the investigators, " was the most common

finding associated with radiographically defined angle of kyphosis. "

Nevertheless, the mean age-adjusted Cobb angle was significantly greater in

those with vertebral fractures than in those without (p < 0.001).

However, in the upper quartile of Cobb angle distribution, only 36.2% of men

and 36.9% of women had prevalent thoracic vertebral fractures. Only 9.7% of

the men and 32.7% of women with exaggerated kyphosis had osteoporosis at the

hip.

The researchers thus conclude that " kyphosis per se should not be considered

diagnostic of osteoporosis. "

Despite this, they recommend that " patients with exaggerated kyphosis should

be evaluated for underlying osteoporotic fracture. "

J Rheumatol 2004;31:747-752.