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Ann Rheum Dis 2000;59:368-371 doi:10.1136/ard.59.5.368
  • Extended report

Does location of vertebral deformity within the spine influence back pain and disability?

  1. W Cockerilla,
  2. A A Ismaila,
  3. C Cooperb,
  4. C Matthisc,
  5. H Raspec,
  6. A J Silmana,
  7. T W O'Neilla,
  8. the European Vertebral Osteoporosis Study (EVOS) Group*
  1. aARC Epidemiology Research Unit, University of Manchester, Stopford Building, Manchester M13 9PT, bMRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton, cInstitute for Social Medicine, Medical University of Lubeck, Lubeck, Germany
  1. Dr O'Neill
  • Accepted 10 December 1999

Abstract

OBJECTIVE Vertebral deformity is associated with back pain and disability. The aim of this analysis was to determine whether location within the spine influences the strength of association between vertebral deformity, back pain and disability.

METHODS Men and women aged 50 years and over were recruited from population registers in 30 European centres. Subjects were invited for an interviewer administered questionnaire, and for lateral spinal radiographs. The questionnaire included questions about back pain, general health and functional ability. The spinal radiographs were evaluated morphometrically and vertebral deformity defined according to the McCloskey-Kanis method.

RESULTS 756 (11.7%) men and 885 (11.8%) women had evidence of one or more vertebral deformities. Among women with a single deformity, after adjusting for age and centre, those with a lumbar deformity were more likely than those with a thoracic deformity to report back pain, both currently (OR=1.4; 95% CI 1.0, 2.0) and in the past year (OR=1.5; 95% CI 1.0, 2.3). No association was observed in men. Among women with two deformities, those with adjacent deformities were more likely than those with non-adjacent deformities to report poor general health (OR=2.2; 95%CI 0.9, 5.6), impaired functional ability (OR=1.9; 95%CI 0.8, 4.7) and current back pain (OR=2.1; 95%CI 0.9, 4.9), though none of these associations were statistically significant. By contrast, among men, non-adjacent deformities were associated with impaired functional ability compared with those with adjacent deformities.

CONCLUSION Location within the spine influences the strength of association between self reported health factors and vertebral deformity.

Footnotes

  • ↵* Members of the EVOS Group are shown at the end of the article.

  • Funding: the study was financially supported by a central coordination grant from the European Community's Concerted action in Epidemiology programme. The central coordination was also supported by the World Health Organisation, the European Foundation for Osteoporosis and Bone Disease and the UK Arthritis Research Campaign. Individual participating centres acknowledge the receipt of locally acquired support for their data collection.

  • Members of the EVOS Group

    Project Management Group D Agnusdei (Siena, Italy), K Bergmann (Berlin, Germany), C Cooper (Southampton, UK), J Dequeker (Leuven, Belgium), D Felsenberg (Berlin, Germany), J A Kanis (Sheffield, UK), G Kruskemper (Bochum, Germany), H Raspe (Berlin, Germany), A J Silman (Project Leader, Manchester, UK). Radiology Coordinating Centre (Berlin) D Felsenberg, E Weiland, L Kaldis, J Mews. Data Coordinating Centre (Manchester) D Finn, T W O'Neill, W Cockerill, A A Ismail, A J Silman.

    Participants Austria: Graz T Lauermann, K Weber;Belgium: Leuven J Dequeker, P Geusens;Croatia: Zagreb I Jajic;Czech Republic/Slovakia: Prague S Havelka, P Vavrincova; Piestany A Letkovska, P Masaryk;France: Montceau-Les-Mines P D Delmas, F Marchand; Germany: Berlin, Steglitz D Felsenberg Berlin, Potsdam D BanzerBerlin, Charite S Kirschner, W Reisinger;Bochum J Janott, H SchatzErfut J FrankeHeidelberg C Scheidt-Nave, R Zeigler;Jena K Abendroth, B Felsch;Lubeck C Matthis, H Raspe;Greece: Athens A Antoniou, G Lyritis;Hungary: Budapest C Kiss, G Poor;Italy: Siena D Agnusdei, C Gennari;Milan S Ortolani;Netherlands: Rotterdam A Hofman, H A P Pols;Norway: Oslo J A Falch, H E Meyer;Poland: Szczecin; S Czekalski, T Miazgowski;Warsaw K Hoszowski, R S Lorenc;Portugal: Oporto A Aroso, A Lopez Vaz;Russia: Moscow L I Benevolenskaya, E E Mikhailov; Spain: Barcelona D Roig Escofet, M Ruiz Martin; Canary Islands M Sosa; Madrid; M Diaz Curiel, A Rapado Oveido J B Cannata Andia, J B Diaz Lopez; Sweden: MalmoO Johnell, B Nilsson; Turkey: Istanbul G Dilsen; United Kingdom: Aberdeen D M ReidBath A K Bhalla, F RingCambridge C Todd, R WilliamsHarrow J ReeveSheffield R EastellTruro A D Woolf.

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