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Published in: Osteoporosis International 3/2013

Open Access 01-03-2013 | Original Article

Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study

Authors: H. Kitahara, Z. Ye, K. Aoyagi, P. D. Ross, Y. Abe, S. Honda, M. Kanagae, S. Mizukami, Y. Kusano, M. Tomita, H. Shindo, M. Osaki

Published in: Osteoporosis International | Issue 3/2013

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Abstract

Summary

We examined the spinal distribution of the types of vertebral deformities and the associations of vertebral deformities and osteoarthritis with back pain in Japanese women. Midthoracic and upper lumbar vertebrae were more susceptible to deformity. Vertebral deformity and osteoarthritis were frequent and were associated with back pain.

Introduction

Vertebral fractures due to osteoporosis and osteoarthritis are both common and significant health problems in aged people. However, little is known about the descriptive epidemiology of the individual deformity types and the relative clinical impact in women in Japan.

Methods

Lateral radiographs were obtained from 584 Japanese women ages 40 to 89 years old. Deformities were defined as vertebral heights of more than 3 standard deviations (SDs) below the normal mean. Osteoarthritis was defined as Kellgren–Lawrence (KL) grade 2 or higher. Information on upper or low back pain during the previous month was collected by questionnaire. We compared the spinal distribution of the three types of vertebral deformities (wedge, endplate, and crush) typical of fractures and examined the associations of number and type of vertebral deformities and osteoarthritis with back pain.

Results

Fifteen percent of women had at least one vertebral deformity and 74% had vertebral osteoarthritis. The prevalence of upper or low back pain was 30.1%. Deformities were most common in the midthoracic and upper lumbar regions and wedge was the frequent type, followed by endplate and crush. Multiple logistic regression analysis showed that the odds of back pain was 3.0 (95% CI 1.5–6.3) times higher for women with a single wedge deformity and 3.2 (95% CI 1.0-–0.6) times higher for women with two or more wedge deformities, compared to women with no wedge deformity. Vertebral osteoarthritis was associated with back pain (OR 1.8, 95% CI 1.1–2.9), independent of other covariates including age and deformities.

Conclusion

Our results in this group of Japanese women are similar to and consistent with results reported previously in other populations of Japanese and Caucasians.
Literature
1.
go back to reference Silverman SL, Piziak VK, Chen P, Misurski DA, Wagman RB (2005) Relationship of health related quality of life to prevalent and new or worsening back pain in postmenopausal women with osteoporosis. J Rheumatol 32:2405–2409PubMed Silverman SL, Piziak VK, Chen P, Misurski DA, Wagman RB (2005) Relationship of health related quality of life to prevalent and new or worsening back pain in postmenopausal women with osteoporosis. J Rheumatol 32:2405–2409PubMed
2.
go back to reference Badia X, Diez-Perez A, Alvarez-Sanz C, Diaz-Lopez B, Diaz-Curiel M, Guillen F, Gonzalez-Macias J (2001) Measuring quality of life in women with vertebral fractures due to osteoporosis: a comparison of the OQLQ and QUALEFFO. Qual Life Res 10:307–317PubMedCrossRef Badia X, Diez-Perez A, Alvarez-Sanz C, Diaz-Lopez B, Diaz-Curiel M, Guillen F, Gonzalez-Macias J (2001) Measuring quality of life in women with vertebral fractures due to osteoporosis: a comparison of the OQLQ and QUALEFFO. Qual Life Res 10:307–317PubMedCrossRef
3.
go back to reference Begerow B, Pfeifer M, Pospeschill M, Scholz M, Schlotthauer T, Lazarescu A, Pollaehne W, Minne HW (1999) Time since vertebral fracture: an important variable concerning quality of life in patients with postmenopausal osteoporosis. Osteoporos Int 10:26–33PubMedCrossRef Begerow B, Pfeifer M, Pospeschill M, Scholz M, Schlotthauer T, Lazarescu A, Pollaehne W, Minne HW (1999) Time since vertebral fracture: an important variable concerning quality of life in patients with postmenopausal osteoporosis. Osteoporos Int 10:26–33PubMedCrossRef
4.
go back to reference Ross PD, Davis JW, Epstein RS, Wasnich RD (1991) Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 114:919–923PubMed Ross PD, Davis JW, Epstein RS, Wasnich RD (1991) Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 114:919–923PubMed
5.
go back to reference Lunt M, O’Neill TW, Felsenberg D, Reeve J, Kanis JA, Cooper C, Silman AJ (2003) Characteristics of a prevalent vertebral deformity predict subsequent vertebral fracture: results from the European Prospective Osteoporosis Study (EPOS). Bone 33:505–513PubMedCrossRef Lunt M, O’Neill TW, Felsenberg D, Reeve J, Kanis JA, Cooper C, Silman AJ (2003) Characteristics of a prevalent vertebral deformity predict subsequent vertebral fracture: results from the European Prospective Osteoporosis Study (EPOS). Bone 33:505–513PubMedCrossRef
6.
go back to reference Eastell R, Cedel SL, Wahner HW, Riggs BL, Melton LJ 3rd (1991) Classification of vertebral fractures. J Bone Miner Res 6:207–215PubMedCrossRef Eastell R, Cedel SL, Wahner HW, Riggs BL, Melton LJ 3rd (1991) Classification of vertebral fractures. J Bone Miner Res 6:207–215PubMedCrossRef
7.
go back to reference Sadat-Ali M, Gullenpet AH, Al-Mulhim F, Al Turki H, Al-Shammary H, Al-Elq A, Al-Othman A (2009) Osteoporosis-related vertebral fractures in postmenopausal women: prevalence in a Saudi Arabian sample. East Mediterr Health J 15:1420–1425PubMed Sadat-Ali M, Gullenpet AH, Al-Mulhim F, Al Turki H, Al-Shammary H, Al-Elq A, Al-Othman A (2009) Osteoporosis-related vertebral fractures in postmenopausal women: prevalence in a Saudi Arabian sample. East Mediterr Health J 15:1420–1425PubMed
8.
go back to reference Clark P, Cons-Molina F, Deleze M, Ragi S, Haddock L, Zanchetta JR, Jaller JJ, Palermo L, Talavera JO, Messina DO, Morales-Torres J, Salmeron J, Navarrete A, Suarez E, Perez CM, Cummings SR (2009) The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporos Int 20:275–282PubMedCrossRef Clark P, Cons-Molina F, Deleze M, Ragi S, Haddock L, Zanchetta JR, Jaller JJ, Palermo L, Talavera JO, Messina DO, Morales-Torres J, Salmeron J, Navarrete A, Suarez E, Perez CM, Cummings SR (2009) The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporos Int 20:275–282PubMedCrossRef
9.
go back to reference Spector TD, McCloskey EV, Doyle DV, Kanis JA (1993) Prevalence of vertebral fracture in women and the relationship with bone density and symptoms: the Chingford Study. J Bone Miner Res 8:817–822PubMedCrossRef Spector TD, McCloskey EV, Doyle DV, Kanis JA (1993) Prevalence of vertebral fracture in women and the relationship with bone density and symptoms: the Chingford Study. J Bone Miner Res 8:817–822PubMedCrossRef
10.
go back to reference O’Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ (1996) The prevalence of vertebral deformity in european men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018PubMedCrossRef O’Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ (1996) The prevalence of vertebral deformity in european men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018PubMedCrossRef
11.
go back to reference McKiernan FE (2009) The broadening spectrum of osteoporotic vertebral fracture. Skeletal Radiol 38:303–308PubMedCrossRef McKiernan FE (2009) The broadening spectrum of osteoporotic vertebral fracture. Skeletal Radiol 38:303–308PubMedCrossRef
12.
go back to reference Fechtenbaum J, Cropet C, Kolta S, Verdoncq B, Orcel P, Roux C (2005) Reporting of vertebral fractures on spine X-rays. Osteoporos Int 16:1823–1826PubMedCrossRef Fechtenbaum J, Cropet C, Kolta S, Verdoncq B, Orcel P, Roux C (2005) Reporting of vertebral fractures on spine X-rays. Osteoporos Int 16:1823–1826PubMedCrossRef
13.
go back to reference Ismail AA, Cooper C, Felsenberg D, Varlow J, Kanis JA, Silman AJ, O’Neill TW (1999) Number and type of vertebral deformities: epidemiological characteristics and relation to back pain and height loss. European Vertebral Osteoporosis Study Group. Osteoporos Int 9:206–213PubMedCrossRef Ismail AA, Cooper C, Felsenberg D, Varlow J, Kanis JA, Silman AJ, O’Neill TW (1999) Number and type of vertebral deformities: epidemiological characteristics and relation to back pain and height loss. European Vertebral Osteoporosis Study Group. Osteoporos Int 9:206–213PubMedCrossRef
14.
go back to reference Mann T, Oviatt SK, Wilson D, Nelson D, Orwoll ES (1992) Vertebral deformity in men. J Bone Miner Res 7:1259–1265PubMedCrossRef Mann T, Oviatt SK, Wilson D, Nelson D, Orwoll ES (1992) Vertebral deformity in men. J Bone Miner Res 7:1259–1265PubMedCrossRef
15.
go back to reference Melton LJ 3rd, Kan SH, Frye MA, Wahner HW, O’Fallon WM, Riggs BL (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011PubMed Melton LJ 3rd, Kan SH, Frye MA, Wahner HW, O’Fallon WM, Riggs BL (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011PubMed
16.
go back to reference Ross PD, Fujiwara S, Huang C, Davis JW, Epstein RS, Wasnich RD, Kodama K, Melton LJ 3rd (1995) Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US. Int J Epidemiol 24:1171–1177PubMedCrossRef Ross PD, Fujiwara S, Huang C, Davis JW, Epstein RS, Wasnich RD, Kodama K, Melton LJ 3rd (1995) Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US. Int J Epidemiol 24:1171–1177PubMedCrossRef
17.
go back to reference Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449–456PubMedCrossRef Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449–456PubMedCrossRef
18.
go back to reference O’Neill TW, McCloskey EV, Kanis JA, Bhalla AK, Reeve J, Reid DM, Todd C, Woolf AD, Silman AJ (1999) The distribution, determinants, and clinical correlates of vertebral osteophytosis: a population based survey. J Rheumatol 26:842–848PubMed O’Neill TW, McCloskey EV, Kanis JA, Bhalla AK, Reeve J, Reid DM, Todd C, Woolf AD, Silman AJ (1999) The distribution, determinants, and clinical correlates of vertebral osteophytosis: a population based survey. J Rheumatol 26:842–848PubMed
19.
go back to reference Yoshimura N, Muraki S, Oka H, Mabuchi A, Kinoshita H, Yosihda M, Kawaguchi H, Nakamura K, Akune T (2009) Epidemiology of lumbar osteoporosis and osteoarthritis and their causal relationship—is osteoarthritis a predictor for osteoporosis or vice versa?: the Miyama study. Osteoporos Int 20:999–1008PubMedCrossRef Yoshimura N, Muraki S, Oka H, Mabuchi A, Kinoshita H, Yosihda M, Kawaguchi H, Nakamura K, Akune T (2009) Epidemiology of lumbar osteoporosis and osteoarthritis and their causal relationship—is osteoarthritis a predictor for osteoporosis or vice versa?: the Miyama study. Osteoporos Int 20:999–1008PubMedCrossRef
20.
go back to reference Pye SR, Reid DM, Smith R, Adams JE, Nelson K, Silman AJ, O’Neill TW (2004) Radiographic features of lumbar disc degeneration and self-reported back pain. J Rheumatol 31:753–758PubMed Pye SR, Reid DM, Smith R, Adams JE, Nelson K, Silman AJ, O’Neill TW (2004) Radiographic features of lumbar disc degeneration and self-reported back pain. J Rheumatol 31:753–758PubMed
21.
go back to reference Borenstein D (2004) Does osteoarthritis of the lumbar spine cause chronic low back pain? Curr Rheumatol Rep 6:14–19PubMedCrossRef Borenstein D (2004) Does osteoarthritis of the lumbar spine cause chronic low back pain? Curr Rheumatol Rep 6:14–19PubMedCrossRef
22.
go back to reference Muraki S, Oka H, Akune T, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N (2009) Prevalence of radiographic lumbar spondylosis and its association with low back pain in elderly subjects of population-based cohorts: the ROAD study. Ann Rheum Dis 68:1401–1406PubMedCrossRef Muraki S, Oka H, Akune T, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N (2009) Prevalence of radiographic lumbar spondylosis and its association with low back pain in elderly subjects of population-based cohorts: the ROAD study. Ann Rheum Dis 68:1401–1406PubMedCrossRef
23.
go back to reference de Schepper EI, Damen J, van Meurs JB, Ginai AZ, Popham M, Hofman A, Koes BW, Bierma-Zeinstra SM (2010) The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features. Spine 35:531–536PubMedCrossRef de Schepper EI, Damen J, van Meurs JB, Ginai AZ, Popham M, Hofman A, Koes BW, Bierma-Zeinstra SM (2010) The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features. Spine 35:531–536PubMedCrossRef
24.
go back to reference Ross PD, Ettinger B, Davis JW, Melton LJ 3rd, Wasnich RD (1991) Evaluation of adverse health outcomes associated with vertebral fractures. Osteoporos Int 1:134–140PubMedCrossRef Ross PD, Ettinger B, Davis JW, Melton LJ 3rd, Wasnich RD (1991) Evaluation of adverse health outcomes associated with vertebral fractures. Osteoporos Int 1:134–140PubMedCrossRef
25.
go back to reference Jinbayashi H, Aoyagi K, Ross PD, Ito M, Shindo H, Takemoto T (2002) Prevalence of vertebral deformity and its associations with physical impairment among Japanese women: The Hizen-Oshima Study. Osteoporos Int 13:723–730PubMedCrossRef Jinbayashi H, Aoyagi K, Ross PD, Ito M, Shindo H, Takemoto T (2002) Prevalence of vertebral deformity and its associations with physical impairment among Japanese women: The Hizen-Oshima Study. Osteoporos Int 13:723–730PubMedCrossRef
26.
go back to reference Gallagher JC, Hedlund LR, Stoner S, Meeger C (1988) Vertebral morphometry: normative data. Bone Miner 4:189–196PubMed Gallagher JC, Hedlund LR, Stoner S, Meeger C (1988) Vertebral morphometry: normative data. Bone Miner 4:189–196PubMed
27.
go back to reference Spencer N, Steiger P, Cummings S, Genant H (1990) Placement of points for digitizing spine films. J Bone Miner Res(abstract) 5(supple 2):s247 Spencer N, Steiger P, Cummings S, Genant H (1990) Placement of points for digitizing spine films. J Bone Miner Res(abstract) 5(supple 2):s247
28.
go back to reference Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502PubMedCrossRef Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502PubMedCrossRef
29.
go back to reference Cooper C, O’Neill T, Silman A (1993) The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group. Bone 14(Suppl 1):S89–S97PubMedCrossRef Cooper C, O’Neill T, Silman A (1993) The epidemiology of vertebral fractures. European Vertebral Osteoporosis Study Group. Bone 14(Suppl 1):S89–S97PubMedCrossRef
30.
go back to reference Gong H, Zhang M, Yeung HY, Qin L (2005) Regional variations in microstructural properties of vertebral trabeculae with aging. J Bone Miner Metab 23:174–180PubMedCrossRef Gong H, Zhang M, Yeung HY, Qin L (2005) Regional variations in microstructural properties of vertebral trabeculae with aging. J Bone Miner Metab 23:174–180PubMedCrossRef
31.
go back to reference Huang C, Ross PD, Wasnich RD (1996) Vertebral fractures and other predictors of back pain among older women. J Bone Miner Res 11:1026–1032PubMedCrossRef Huang C, Ross PD, Wasnich RD (1996) Vertebral fractures and other predictors of back pain among older women. J Bone Miner Res 11:1026–1032PubMedCrossRef
32.
go back to reference Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K, Segal M, Genant HK, Cummings SR (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800PubMed Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K, Segal M, Genant HK, Cummings SR (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800PubMed
33.
go back to reference Francis RM, Aspray TJ, Hide G, Sutcliffe AM, Wilkinson P (2008) Back pain in osteoporotic vertebral fractures. Osteoporos Int 19:895–903PubMedCrossRef Francis RM, Aspray TJ, Hide G, Sutcliffe AM, Wilkinson P (2008) Back pain in osteoporotic vertebral fractures. Osteoporos Int 19:895–903PubMedCrossRef
34.
go back to reference Ross PD, Davis JW, Epstein RS, Wasnich RD (1994) Pain and disability associated with new vertebral fractures and other spinal conditions. J Clin Epidemiol 47:231–239PubMedCrossRef Ross PD, Davis JW, Epstein RS, Wasnich RD (1994) Pain and disability associated with new vertebral fractures and other spinal conditions. J Clin Epidemiol 47:231–239PubMedCrossRef
Metadata
Title
Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study
Authors
H. Kitahara
Z. Ye
K. Aoyagi
P. D. Ross
Y. Abe
S. Honda
M. Kanagae
S. Mizukami
Y. Kusano
M. Tomita
H. Shindo
M. Osaki
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 3/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-012-2038-2

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