Vertebral Morphometry

Abstract

Epidemiological studies (Cooper 1995; Davies et al. 1996; Melton 1996; Wasnich 1996) have found a high prevalence of vertebral fractures, which are considered the most common of all osteoporotic fractures. It is estimated that 25% of postmenopausal women and of men aged over 50 years in the USA (Melton 1997; Samelson et al. 1999) and 20% in Europe (O’Neill et al. 1996) have vertebral fractures. A diagnosis of vertebral fracture is a frequently used endpoint in clinical trials and epidemiological studies investigating the effectiveness of different therapeutic regimens on osteoporosis(Cummings et al. 1998; Hochberg et al. 1999; Kanis et al. 1991; Liberman et al. 1995; National Osteoporosis Foundation Working Group on Vertebral Fractures 1995; Nevitt et al. 1999). Vertebral fractures are really vertebral deformities, classified as anterior wedging, biconcavity and crushing resulting from the loss of anterior, middle and posterior heights of vertebral bodies (Fig. 7.1). The diagnosis of severe vertebral fractures by visual reading of conventional radiographs of the thoracic and lumbar spine in lateral and anteroposterior projections is generally uncomplicated. However, osteoporotic vertebral fractures often appear as mild vertebral deformities, atraumatic and asymptomatic, so that the visual radiological approach may lead to disagreement about whether a vertebra is fractured (Hedlund and Gallagher 1998). In an effort to reduce the high subjectivity and poor reproducibility of qualitative readings, more than a decade ago morphometric methods based on vertebral height measurements to definite vertebral fractures were introduced.KeywordsVertebral FractureVertebral DeformityVertebral HeightOsteoporotic Vertebral FractureVertebral Body HeightThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.