학술논문

Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial
Document Type
article
Source
Osteoporosis International. 27(3)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Health Sciences
Osteoporosis
Rehabilitation
Clinical Research
Physical Injury - Accidents and Adverse Effects
Musculoskeletal
Injuries and accidents
Aged
Aged
80 and over
Bone Density
Female
Femur Neck
Humans
Incidence
Kyphosis
Lumbar Vertebrae
Middle Aged
Osteoporosis
Postmenopausal
Osteoporotic Fractures
Prevalence
Risk Factors
Spinal Fractures
Thoracic Vertebrae
United States
Vertebral fracture
Biomedical Engineering
Public Health and Health Services
Endocrinology & Metabolism
Clinical sciences
Epidemiology
Language
Abstract
SummaryBiomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture.IntroductionBiomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture.MethodsWe used data from the Fracture Intervention Trial among 3038 women 55-81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD.ResultsMean baseline kyphosis was 48° (SD = 12) (range 7-83). At baseline, 962 (32%) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95% CI 2.8-4.6, p