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Youn and Kim: The Assessment of Bone Mineral Density in The Lumbar Vertebra Using Quantitative Computed Tomography
Original Article

Journal of Korean Spine Surg 2006;13(4):255-261.

Published online: 21 February 2006

DOI: https://doi.org/10.4184/jkss.2006.13.4.255

The Assessment of Bone Mineral Density in The Lumbar Vertebra Using Quantitative Computed Tomography

Te Hyun Youn, M.D., Jong Sik Kim, M.D.

Department of Orthopedic Surgery, Seonam University Namkwang Hospital, Gwangju, Korea

Address reprint requests to Jong Sik Kim, M.D. Department of Orthopedic Surgery, Seonam University Namkwang Hospital 120-1 Maruk-dong, Seo-gu, Gwangju, 506-157, Korea. Tel: 82-62-370-7754, Fax: 82-62-371-3092, E-mail: jongos77@hanmail.net

Copyright © 2006 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Retrospective study

Objectives

This study evaluated the relationship between the bone mineral density (BMD) and low back pain and between BMD and the spinal fractures of postmenopausal women and to determine threshold value of the fracture.

Summary and Literature Review

Low back pain was not associated with a decreased BMD, and BMD of the spine fracture group with osteoporosis was significantly lower than the non fracture group. The threshold of fracture was 99 mg/cm3 in the 90th percentile.

Materials and Methods

Of 324 subjects between January 2003 to December 2004, postmenopausal women, in whom the mean value of BMD and lumbar vertebrae (L2, L3, L4) were measured by quantitative computed tomography (QCT), were given a questionnaire regarding the level of low back pain over the previous twelve months. The low back pain was divided several groups according to frequency: none, some of the time and most of the time. The spinal fracture was assessed by a simple radiology measurement and divided its into the fracture group and non fracture group. In addition, statistical analysis of the BMD with low back pain and with a spinal fracture was performed. The threshold value of the fracture was calculated using the Riggs method.

Results

Of the 324 subjects, there were 34 cases of spinal fractures in whom the fracture was not caused by high energy trauma. Among the non-fracture groups, low back pain was not associated with a lower BMD. The BMD of the spinal fracture group with osteoporosis was significantly lower than in the non fracture group (p�0.01). The threshold of fracture was 99 mg/cm3 in the 90th percentile.

Conclusions

It is recommended that the BMD be measured in women in whom more than 5 years has passed since menopause, even if they show no symptoms. In addition, osteoporosis patients with a BMD �99 mg/cm3 will need to be treated more intensively.

Keywords: BMD, QCT, Spinal fracture, Postmenopausal women

REFERENCES

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Figures and Tables%

Fig. 1.
BMD change according to age in postmenopausal women.
jkss-13-255f1.tif
Fig. 2.
The rate of loss of BMD with aging in postmenopausal women
jkss-13-255f2.tif
Table 1.
Prevalence of back pain by BMD Z-score in non fracture group
Frequency of back pain
BMD Z-SCORE TOTAL No. (%) Never No. (%) Rarely or some of the time No. (%) Most or all of the time No. (%)
above -1.0 SD 105 (100) 47 (44.8) 56 (53.3) 2 (1.9)
-1.0 SD ~ -2.0 SD 187 (100) 38 (43.7) 48 (55.2) 1 (1.1)
-2.0 SD ~ -3.0 SD 152 (100) 23 (44.2) 29 (55.8) 1 (1.9)
-3.0 SD ~ -4.0 SD 111 (100) 25 (45.5) 06 (54.4) 0 (1.0)
TOTAL (No.) 255 113 139 4
Table 2.
Comparison of BMD and frequency of spinal fracture in each age group
Age Total (No.) Fx. (No.) Non-Fx. (No.) QCT (Mean)
40~44 06 0 (110%) 16 166.3±23.4
45~49 26 0 (110%) 26 159.6±20.5
50~54 39 2 (15.1%) 37 133.7±25.3
55~59 56 2 (13.6%) 54 117.7±21.8
60~64 54 3 (05.6%) 51 103.2±20.7
65~69 53 9 (17.0%) 44 178.0±18.6
70~74 54 7 (13.0%) 47 172.3±20.2
75~79 19 4 (21.1%) 15 152.9±17.2
80> 17 7 (41.2%) 10 134.4±16.3

Fx.: Fracture

QCT (mg/cm3)

Table 3.
Comparison of age and BMD in the non-fracture group and the fracture group
Non Fx (N=290) Fx (N=34)
Age 61.9±6.3 70.4±7.1
BMD 105.4±20.3 48.3±18.4 (p<0.01)

Fx.: Fracture

* QCT (mg/cm3

By using ANACOVA test, controlled for potential confounding factor, such as age

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