Author(s): Prince RL, Devine A, Dick IM, Prince RL, Devine A, Dick IM
Abstract Share this page
Abstract Meaured spinal kyphosis, as a predictor of prevalent and incident vertebral deformity, was examined in older women (>70 years) and found to not have sufficient sensitivity or specificity to justify its use as a predictor of present or future vertebral deformity risk. INTRODUCTION: Kyphosis may be attributable to vertebral deformity and was investigated as a clinical tool for predicting the presence and future risk of vertebral deformity. METHODS: Kyphosis was measured in 434 women aged 70 years or older and the kyphosis index (KI) calculated. Prevalent and incident vertebral deformities were assessed by morphometric X-ray absorptiometry (MXA). The predictive value of KI was examined. RESULTS: Severity of kyphosis was categorised by tertile of KI; 65\% of anterior thoracic deformities occurred in the 33\% of subjects in the highest (most kyphotic) tertile. Using this tertile as a predictor of anterior thoracic deformity, the probability for a positive test rose from 14\% for the whole population to 28\% and for a negative test the probability fell to 8\%. For any spinal deformity the highest tertile of KI increased the probability of a positive test from 34\% to 42\% and reduced the probability for a negative test to 30\%. The incidence of new deformities was 6\% over 4 years; a high KI tertile did not increase the probability of any vertebral deformity. CONCLUSIONS: Severe kyphosis does not increase the probability of detection of a prevalent or incident spinal deformity sufficiently to make it a useful method of selecting patients for further evaluation of spinal deformity.
This article was published in Osteoporos Int
and referenced in Journal of Clinical Trials