Correlation of Lumbar Bone Mineral Density with Degenerative
Changes of the Spine and Knee
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척추 및 슬관절의 퇴행성 변화와 요추 골밀도의 상관관계 |
양익환,김보람,박진오,박시영,장준섭,이환모,문성환 |
연세대학교 의과대학 정형외과학교실 |
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Abstract |
Background Osteoporosis and primary osteoarthritis (OA) are both common conditions in elderly women. Many studies demonstrated an inverse correlation between osteoporosis and OA. OA of the knee appears to increase bone mineral density (BMD) while increasing the risk of vertebral and non vertebral fracture. Nevertheless, combined effect of OA of the spine and knee on BMD and osteoporotic facture is not conclusive. Accordingly, the objective of the current study was to evaluate the effect of degenerative changes of the spine and knee on lumbar BMD and prevalent osteoporotic vertebral fracture.
Materials and Methods: One hundred ninety six postmenopausal women (mean 65 years old, range from 52 to 87 years old) were included in the study. Standard anterior-posterior and lateral radiographs of the spine were taken in standardized manner. Standing anterior-posterior radiograph of the knee was also taken. Lumbar BMD was measured with dual energy X-ray absorptiometry. The degenerative changes of the lumbar spine were scored with qualitative and quantitative criteria (0 to 28 points). The degenerative changes of the knee were graded by Kellgren-Lawrence method (grade 0 to 4). Prevalent vertebral fractures were identified by morphometric assessment.
Results There was a significant correlation of degenerative scores of the lumbar spine and Kellgren- Lawrence grade of the knee. In multiple regression analysis including age, height, body weight, menopause, degenerative score of the spine, and Kellgren-Lawrence grade of the knee on lumbar BMD, there was small but significant effect of degenerative score of the spine and Kellgren-Lawrence grade of the knee on lumbar BMD (partial R2=0.406, p=0.014: partial R2=0.393, p=0.021). Patients with spinal OA (score, 5<) exhibited low rate of prevalent vertebral fracture (p<0.05), while those with knee OA (Kellgren-Lawrence grade 2≦) showed no significant changes in the rate of prevalent vertebral fracture.
Conclusion OAs of the |
Key Words:
Spine, Knee, Osteoarthritis, Osteoporosis, BMD |
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