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Spinal deformity index (SDI) is a good predictor of incident vertebral fractures
S Kerkeni1, S Kolta, J Fechtenbaum
1Cochin Hospital, Rheumatology Department, Paris Descartes University, Paris, France.
Unlabelled:
The spinal deformity index is a convenient tool to quantify the number and the severity of prevalent vertebral fractures. It is a predictor of the risk of sustaining incident vertebral fracture. This quantification must be taken into account to improve management of patients.
Introduction:
Prevalent fractures are strong risk factors for subsequent fractures.
Methods:
The study subjects were women from the placebo groups of two studies of strontium ranelate in postmenopausal osteoporosis (N = 723 and 637 patients, respectively). Three lateral radiographs of the spine were obtained at baseline and annually over 3 years, according to standardized procedures. The semiquantitative visual assessment of each vertebra from T4 to L4 was performed by the same reader throughout the study. A spinal deformity index (SDI) was calculated by summing for each patient the grade of each vertebra from T4 to L4.
Results:
There was a linear relationship between baseline SDI and the 3-year incidence of vertebral fracture (adjusted R(2) = 0.76). The 3-year incidence of vertebral fractures was different among the tertiles of baseline SDI: 17.3 +/- 3.6%, 25.4 +/- 2.6%, and 47.6 +/- 3.1% from the lowest to the highest, respectively. There was no relationship between SDI and non-vertebral fractures incidence.
Conclusion:
SDI is a good predictor of incident vertebral fractures. Patients with highest SDI should receive highest priority to treatment.
