The Assessment of Bone Mineral Density in The Lumbar Vertebra Using Quantitative Computed Tomography / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: Retrospective study OBJECTIVES: This study evaluated the relationship between the bone mineral density (BMD) and low back pain and between BMD and the spinal fractures of postmenopausal women and to determine threshold value of the fracture. SUMMARY AND LITERATURE REVIEW: Low back pain was not associated with a decreased BMD, and BMD of the spine fracture group with osteoporosis was significantly lower than the non fracture group. The threshold of fracture was 99 mg/cm3 in the 90th percentile. MATERIALS AND METHODS: Of 324 subjects between January 2003 to December 2004, postmenopausal women, in whom the mean value of BMD and lumbar vertebrae (L2, L3, L4) were measured by quantitative computed tomography (QCT), were given a questionnaire regarding the level of low back pain over the previous twelve months. The low back pain was divided several groups according to frequency: none, some of the time and most of the time. The spinal fracture was assessed by a simple radiology measurement and divided its into the fracture group and non fracture group. In addition, statistical analysis of the BMD with low back pain and with a spinal fracture was performed. The threshold value of the fracture was calculated using the Riggs method. RESULTS: Of the 324 subjects, there were 34 cases of spinal fractures in whom the fracture was not caused by high energy trauma. Among the non-fracture groups, low back pain was not associated with a lower BMD. The BMD of the spinal fracture group with osteoporosis was significantly lower than in the non fracture group (p<0.01). The threshold of fracture was 99 mg/cm3 in the 90th percentile. CONCLUSIONS: It is recommended that the BMD be measured in women in whom more than 5 years has passed since menopause, even if they show no symptoms. In addition, osteoporosis patients with a BMD < 99 mg/cm3 will need to be treated more intensively.