Vertebral measurements for assessment of osteoporosis

We measured the vertebral heights and spinal bone mineral density (BMD) of healthy women, and morphometrically evaluated the physiological features of the vertebrae to investigate the relationship of BMD to types of spinal deformity as well as the radiographic detection rate for decreased vertebral bone density. Vertebral BMD was measured from L1 to L4 using dual X-ray absorptiometry and from L1 to L3 using quantitative computed tomography in 245 healthy women ranging in age from 22 to 81 years. The vertebral heights, anterior (Ha), middle (Hm), and posterior (Hp), were measured from T12 through L5, and the Ha/Hp and Hm/Hp ratios were calculated. Although the age-related reduction of vertebral height was not as marked as that of BMD, the vertebral heights, especially the Ha and Hm from T12 to L5 vertebrae, and the Ha/Hp and Hm/Hp from T12 to L3, significantly decreased with age. The presence of a wedge-shaped deformity was strongly related to cortical BMD, and biconcave deformity to trabecular BMD. Although investigation of the sensitivity and specificity of several criteria revealed that vertebra-specific dimension criteria are useful in the detection of decreased bone density, the detection of decreased BMD using vertebral measurements is considered to be limited.