Vertebral morphometry in diagnosis of spinal fractures

Vertebral morphometry was performed on lateral thoracic and lumbar radiographs of 153 women with a preliminary diagnosis of spinal osteoporosis. Measurements included anterior and posterior vertebral height, width, area, wedge angle, percent reduction of anterior to posterior height (PRH) and percent difference in anterior height between adjoining vertebrae (PDAH). A vertebral fracture was identified if any of the measurements which control for interindividual variation in vertebral size (wedge angle, PRH, PDAH) were below the normal range. Among individuals with mild osteoporosis (0-2 fractures) PDAH identified 86% of the fractures and 95% of the individuals with fractures. Other measurements identified less than 71% of the fractures and less than 80% of the individuals with fractures. Although the results reflect a relative rather than a true sensitivity it appears that PDAH is the better diagnostic measurement for fractures in the earlier stages of spinal osteoporosis.