Association of Continuous Vertebral Bone Bridges and Bone Mineral Density with the Fracture Risk in Patients with Diffuse Idiopathic Skeletal Hyperostosis

被引:9
作者
Furukawa, Mitsuru [1 ]
Okuyama, Kunimasa [2 ]
Ninomiya, Ken [2 ]
Yato, Yoshiyuki [1 ]
Miyamoto, Takeshi [3 ]
Nakamura, Masaya [4 ]
Matsumoto, Morio [4 ]
机构
[1] Murayama Med Ctr, Dept Orthoped Surg, 2-37-11 Gakuen, Tokyo 2080011, Japan
[2] Shizuoka City Shimizu Hosp, Dept Orthoped Surg, Shizuoka, Japan
[3] Kumamoto Univ, Dept Orthoped Surg, Kumamoto, Japan
[4] Keio Univ, Dept Orthoped Surg, Tokyo, Japan
关键词
Diffuse idiopathic skeletal hyperostosis; Spinal fractures; Ankylosis; BODY-MASS INDEX; ANKYLOSING-SPONDYLITIS; SPINE; DISH;
D O I
10.31616/asj.2020.0352
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Study design: Cross-sectional study. Purpose: To examine whether the number of continuous vertebral bone bridges and bone mineral density (BMD) influence the fracture risk in diffuse idiopathic skeletal hyperostosis (DISH) patients. Overview of literature: Bone bridges connecting through the intervertebral body in DISH create long lever arms that can increase the risk of fractures from minor trauma. DISH patients have a BMD that is higher than or comparable to those of age-matched healthy subjects. Methods: We examined the computed tomography scans from the thoracic vertebra to the sacrum used to diagnose DISH in 140 patients (98 men and 42 women; average age, 78.6 years). We compared patients who did (n=52) and did not have (n=88) fractures at the continuous vertebral bodies fused by bone bridges. The relationship between the vertebral fractures and the maximum number of vertebrae that are bony cross-linked with contiguous adjacent vertebrae (max VB) from the thoracic vertebra to the sacrum or from the lumbar vertebra to the sacrum and proximal femur BMD were analyzed using a logistic regression model. Results: We found that after adjusting for the confounding factors, higher max VB, both from the thoracic vertebrae to the sacrum and the lumbar vertebrae to the sacrum, was associated with a higher risk of vertebral fractures. This difference was statistically significant. The risk was higher when only the lumbar vertebrae to the sacrum was considered (thoracic vertebrae to the sacrum: odds ratio, 1.21; p<0.05; lumbar vertebrae to the sacrum: odds ratio, 2.78; p<0.01). Moreover, low proximal femur BMD in DISH patients raises the fracture risk (odds ratio, 0.47; p<0.01). Conclusions: Many continuous vertebral bone bridges, especially those that extend to the lumbar spine and low proximal femur BMD, are risk factors for fracture in DISH patients.
引用
收藏
页码:75 / 81
页数:7
相关论文
共 24 条
[1]   Ankylosing spondylitis [J].
Braun, Juergen ;
Sieper, Joachim .
LANCET, 2007, 369 (9570) :1379-1390
[2]   Spine Fractures in Patients With Ankylosing Spinal Disorders [J].
Caron, Troy ;
Bransford, Richard ;
Nguyen, Quynh ;
Agel, Julie ;
Chapman, Jens ;
Bellabarba, Carlo .
SPINE, 2010, 35 (11) :E458-E464
[3]   Body mass index as a predictor of fracture risk:: A meta-analysis [J].
De Laet, C ;
Kanis, JA ;
Odén, A ;
Johanson, H ;
Johnell, O ;
Delmas, P ;
Eisman, JA ;
Kroger, H ;
Fujiwara, S ;
Garnero, P ;
McCloskey, EV ;
Mellstrom, D ;
Melton, LJ ;
Meunier, PJ ;
Pols, HAP ;
Reeve, J ;
Silman, A ;
Tenenhouse, A .
OSTEOPOROSIS INTERNATIONAL, 2005, 16 (11) :1330-1338
[4]   Diffuse idiopathic skeletal hyperostosis (DISH): relation to vertebral fractures and bone density [J].
Diederichs, G. ;
Engelken, F. ;
Marshall, L. M. ;
Peters, K. ;
Black, D. M. ;
Issever, A. S. ;
Barrett-Connor, E. ;
Orwoll, E. ;
Hamm, B. ;
Link, T. M. .
OSTEOPOROSIS INTERNATIONAL, 2011, 22 (06) :1789-1797
[5]  
Furukawa Mitsuru, 2020, Spine Surg Relat Res, V4, P333, DOI [10.22603/ssrr.2020-0001, 10.22603/ssrr.2020-0001]
[6]   FRACTURE OF THE SPINE IN PATIENTS WITH ANKYLOSIS DUE TO DIFFUSE SKELETAL HYPEROSTOSIS - CLINICAL AND IMAGING FINDINGS [J].
HENDRIX, RW ;
MELANY, M ;
MILLER, F ;
ROGERS, LF .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1994, 162 (04) :899-904
[7]   A Meta-Analysis of the Association of Fracture Risk and Body Mass Index in Women [J].
Johansson, Helena ;
Kanis, John A. ;
Oden, Anders ;
McCloskey, Eugene ;
Chapurlat, Roland D. ;
Christiansen, Claus ;
Cummings, Steve R. ;
Diez-Perez, Adolfo ;
Eisman, John A. ;
Fujiwara, Saeko ;
Glueer, Claus-C ;
Goltzman, David ;
Hans, Didier ;
Khaw, Kay-Tee ;
Krieg, Marc-Antoine ;
Kroeger, Heikki ;
LaCroix, Andrea Z. ;
Lau, Edith ;
Leslie, William D. ;
Mellstroem, Dan ;
Melton, L. Joseph, III ;
O'Neill, Terence W. ;
Pasco, Julie A. ;
Prior, Jerilynn C. ;
Reid, David M. ;
Rivadeneira, Fernando ;
van Staa, Tjerd ;
Yoshimura, Noriko ;
Zillikens, M. Carola .
JOURNAL OF BONE AND MINERAL RESEARCH, 2014, 29 (01) :223-233
[8]  
JULKUNEN H, 1975, SCAND J RHEUMATOL, V4, P23
[9]  
Karberg K, 2005, J RHEUMATOL, V32, P1290
[10]   The Natural Course of Diffuse Idiopathic Skeletal Hyperostosis in the Thoracic Spine of Adult Males [J].
Kuperus, Jonneke S. ;
Buckens, Constantinus F. ;
Sprem, Jurica ;
Oner, F. Cumhur ;
de Jong, Pim A. ;
Verlaan, Jorrit-Jan .
JOURNAL OF RHEUMATOLOGY, 2018, 45 (08) :1116-1123