April 1, 2011

Researchers supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) have demonstrated that mild spine deformities in older women can be due to fractures from osteoporosis, a bone-weakening disease. Their study was recently published in the Journal of Bone and Mineral Research.

Spinal fractures are common in older women and men. When they are more severe, these fractures can result in significant pain, inability to perform daily activities, and deformities of the spine. Whether mild spine deformities represent osteoporosis-related fractures is less clear since commonly employed measures, such as bone density tests, cannot distinguish between bones with mild spine deformities due to fractures and those of healthy counterparts.

To address whether minimal spine deformities represent early osteoporotic fractures, Sundeep Khosla, M.D., and his team from the Mayo Clinic in Rochester, MN, studied a total of 283 older women: 90 of whom were healthy controls, 142 women who had mild spine deformities, and 51 women who had moderate to severe deformities. The investigators used sensitive imaging techniques such as high-resolution peripheral QCT (HRpQCT) to study bone microstructure, and sophisticated mathematical and biomechanical assessments to compare the different groups of women.

Confirming results from their earlier studies, the investigators discovered that the older women with moderate to severe deformities had much worse bone density, structure and strength, as compared to their healthy counterparts. In addition, the investigators discovered that these bone parameters were also worse in older women with milder deformities than in the healthy controls; however, differences were not as pronounced as in the women with moderate to severe deformities. Thus, skeletal parameters of women with milder spine deformities were compromised as compared with the healthy controls, but not as bad as the women with more severe deformities.

This work suggests that minimal spine deformities represent early osteoporotic fractures and can be added to the clinical assessment of osteoporosis risk. Although the study demonstrated a stronger correlation between reduced bone quality and moderate to severe spine deformities, the differences in the bone parameters between women with mild deformities and normal controls were significant. According to Dr. Khosla, the work supports the development of more specific spinal fracture criteria and better techniques to identify risk for mild spine deformities.

The study was also supported by the National Institutes of Health’s Clinical and Translational Science Awards program.The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS website at https://www.niams.nih.gov.


Melton LJ 3rd, Riggs BL, Keaveny TM, Achenbach SJ, Kopperdahl D, Camp JJ, Rouleau PA, Amin S, Atkinson EJ, Robb RA, Therneau TM, Khosla S. Relation of vertebral deformities to bone density, structure, and strength. J Bone Miner Res. 2010 Sep; 25(9):1922-30.

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