Aging changes in vertebral morphometry

Abstract

We analyzed the vertebral morphometry of healthy premenopausal women and their changes with age and menopause in order to better define the reference population for the clinical and epidemiological evaluation of vertebral fractures. Vertebral morphometry has been performed on lateral thoracic and lumbar spine films from 50 premenopausal and 76 postmenopausal normal women, age range 39-74 years. Vertebral heights and the anterior height/posterior height ratio are significantly lower in postmenopausal compared with premenopausal women. Vertebral anterior height decreases about 1.5 mm/year, whereas middle and posterior height decreases about 1.3 and 1.2/mm year, respectively. A statistically significant reduction of vertebral heights by around 1 mm/vertebra was observed in postmenopausal (n = 16) compared with premenopausal women (n = 20) of the same age (P < 0.05). The results demonstrate that vertebral heights are lower with advancing age and menopause and that the vertebral heights difference in elderly people is not only the consequence of a cohort effect. The results also contribute to better defining the reference population to be chosen for evaluating vertebral deformation.

Reference values for vertebral shape in young Chinese women: implication for assessment of vertebral deformity

“…However, there was no significant difference in any type of VH ratio between -3.5 SD and -20% cutoffs (Table 3). Figure 3 shows the average H a /H p and H m /H p ratios for each vertebral body in the present study compared with the data obtained from normal European women by McCloskey et al [11] and Diacinti et al [21] The H a /H p ratio varied with a similar trend between different vertebrae in all three groups. The values were very close between our group and McCloskey's.…”

“…The reference values of VH ratios for women were derived from either premenopausal population [13,21] or a trimming procedure for the data from elderly postmenopausal women [6,16,22], which iteratively removed the number from the upper and lower tails of a distribution of VH ratio until the remaining data became normally distributed [6,14,22]. For both methods, any VH ratio lower than a given percentage or SD (e.g., 15% or 3 SD) below the mean can be regarded as vertebral deformity [6,11,13,15,16,29].…”

“…Cutoff values were set as standard deviation (3, 3.5 and 4 SD) or percentage (15 and 20%) below the means of vertebral height (VH) ratios. To discriminate racial disparity in vertebral shape, we compared our data with those from normal European women (age \50 years) [11,21].…”

“…There are several ways to obtain reference values: (1) from radiographs that have been assessed qualitatively as normal by a clinician or radiologist [15]; (2) using radiographs from normal subjects in whom the risk of vertebral fracture is very low [11,21] and (3) using radiographs from population samples, in which the cases with vertebral deformity need to be excluded by statistical manipulation [6,16,22]. The different sources may yield different reference values [13].…”

“…We propose that normal young adults, who are supposed to have low incidence of vertebral deformity and osteoporotic fractures, is an ideal population for obtaining reference values. In addition, the reference values for vertebral dimensions vary among people of different races and sexes [21][22][23][24]. Accordingly, a set of specific reference values is required for each race-and sexspecific population.…”