Correlation between Osteoporosis and Lumbar Disc Degeneration in Postmenopausal Low Back Pain Patients

Kyu Sung Lee; Soo Hong Han; Byung Soon Kim; Jin Soo Lee

doi:10.4184/jkss.2002.9.1.27

Journal List > J Korean Soc Spine Surg > v.9(1) > 1036028

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Lee, Han, Kim, and Lee: Correlation between Osteoporosis and Lumbar Disc Degeneration in Postmenopausal Low Back Pain Patients

Original Article

Journal of Korean Spine Surg 2002;9(1):27-34.

Published online: 21 February 2002

DOI: https://doi.org/10.4184/jkss.2002.9.1.27

Correlation between Osteoporosis and Lumbar Disc Degeneration in Postmenopausal Low Back Pain Patients

Kyu Sung Lee, M.D., Soo Hong Han, M.D., Byung Soon Kim, M.D., Jin Soo Lee, M.D.

Department of Orthopaedic Surgery, College of Medicine, Pundang CHA Hospital, Pochon CHA University, Sungnam, Korea

Address reprint requests to Kyu Sung Lee, M.D. Department of Orthopaedic Surgery, College of Medicine, Pundang CHA Hospital Yatap-dong, Pundang-gu, Sungnam Kyonggi-do 463-712, Korea Tel : 82-31-780-5270/5273, Fax : 82-31-708-3578, E-mail : chaos5270@hanmail.net

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

The degenerative changes in plain X - ray and bone mineral density of the lumbar spine of postmenopausal women was evaluated retrospectively.

Objective

We analyzed the correlation between degenerative arthritis and osteoporosis of lumbar spine, which are common senile spinal disorders in old age.

Summary of literature Review

Inverse relationship has been reported between osteoporosis and osteoarthritis in the studies of hip fractures

Materials and methods

For 108 female patients older than 50 years of age, the degenerative change of lumbar spine was evaluated by scoring with Kellgren's classification of disc degeneration and with Nathan's classification of osteophyte from radiographs of lumbar spine. Bone mineral density of lumbar spine was measured with dual energy X - ray absorptiometry. Osteoporotic fracture of vertebral body was scored by Renier's index. The correlation between the data of degenerative changes and bone mineral density was analyzed.

Results

Kellgren's score of disc degeneration had positive correlation with lateral lumbar bone mineral density suggested that disc degeneration decreases osteoporosis.

Conclusion

Osteoporosis and osteoarthritis of senile spine had an inverse relationship, and was not simply the end result of normal aging. Understanding of relationship of two disorders would be helpful in treatment decision.

Keywords: Lumbar spine, Osteoporosis, Disc degeneration, Postmenopausal women.

REFERENCES

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Figures and Tables%

Fig. 1.

Pearson's linear correlation coefficient. A: Positive correlation between age and disc degeneration, B: Positive correlation between age and Nathan osteophyte, C: Positive correlation between age and fracture.

Fig. 2.

Pearson's linear correlation coefficient. A: Negative correlation between age and lumbar spine lateral SD*, B: Negative correlation between age and lumbar spine lateral BMD ^#. *SD, Mean standard deviation of T score of DEXA; ^# BMD, Mean bone mineral density(mg/cm²) of T score.

Fig. 3.

Pearson's linear correlation coefficient. A: Positive correlation between disc degeneration and lumbar spine lateral SD*, B: Positive correlation between disc degeneration and lumbar spine lateral BMD^#. *SD, Mean standard deviation of T score of DEXA; ^#BMD, Mean bone mineral density(mg/cm²) of T score.

Table 1.

The distributions of each parameter of patient's age, degenerative change, bone mineral density and fracture of lumbar spine.

	Mean	Max	Mean	SD
Age	50.00	81.00	64.04	8.80
Disc degeneration score	0.00	19.00	7.61	4.34
Osteophyte score	0.00	24.00	11.17	6.16
AP SD^∗	-5.21	1.25	-2.06	1.37
AP BMD^#	0.41	1.18	0.78	0.17
Lat SD^∗	-5.29	0.86	-2.60	1.34
Lat BMD^#	0.32	0.84	0.60	0.11
Fracture score	0.00	17.00	2.07	3.70

^∗ SD, Mean standard deviation of T score of DEXA;

^# BMD, Mean bone mineral density(mg/cm

² ) of T score.

Table 2.

The correlation between each parameters of the age, disc degeneration and bone mineral density.

		Age	Disc degeneration ^A	Osteophyte&	Lat SD^#	Lat BMD\|	Fracture^$
a. Age	r^∗		0.377	0.544	-0.302	-0.315	0.429
	p		0.000	0.000	0.002	0.001	0.000
b. Disc	r			0.712	0.258	0.299	0.165
b. degeneration	p			0.000	0.010	0.002	0.088
c. Osteophyte	r				0.041	0.078	0.225
	p				0.687	0.434	0.019
d. Fracture	r	0.429	0.165	0.225	-0.478	-0.497
	p	0.000	0.088	0.000	0.000	0.000

^∗ r, Pearson Linear Correlation Coefficient; ^Disc degeneration, Kellgren disc degeneration score;

^& Osteophyte, Nathan osteophyte score;

^# SD, Standard deviation;

^| BMD, Bone mineral density(mg/cm

² );

^$ Fracture, Renier's fracture score.

Table 3.

The difference of each parameters between the group with BMD under -2.5 SD and the group with BMD above -2.5 SD.

	Age Mean± SD	Disc degereration^{^} Mean± SD	Osteophyte^& Mean± SD	Lat BMD^\| Mean± SD
<-2.5 SD^$	65.86± 8.73	6.93± 4.18	10.72± 5.67	0.53± 7.22E-02
>-2.5 SD	61.90± 8.77	8.71± 4.58	12.24± 6.87	0.70± 5.68E-02
t-value	2.233	2.022	-1.205	-12.544
p-value	0.028	0.046	0.231	0.000

^{^} Disc degeneration, Kellgren disc degeneration e mineral density(mg/cm²). n score; ^& Osteophyte, Nathan osteo ophyte score; SD, Standard deviation of T score of DEXA; ^| BMD, Bone,

Table 4.

The difference of each parameter between the groups with fracture and without fracture.

	N	Age Mean± SD	Disc d N	degeneration^{^} Mean± SD	N	Osteophyte& Mean± SD	N	Lat BMD^\| Mean± SD
With fracture	46	67.70± 8.90	46	7.70± 3.89	46	12.6± 5.05	46	0.54± 8.41E-02
Without fracture	62	61.32± 7.73	62	7.75± 4.67	62	10.10± 6.71	56	0.65± 0.10
t-value		3.972		0.174		2.129		-5.447
t-value p-value		3.972 0.000		0.174 0.862		2.129 0.036		-5.447 0.000

^{^} Disc degeneration; Kellgren disc degeneration score

^& Osteophyte; Nathan osteophyte score,

^$ SD; Standard deviation,

^| BMD; Bone mineral density(mg/cm²).

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