We have analyzed the relationship between vertebral fractures and spine osteoarthritis in 410 post menopausal women with osteoporosis: in this population both disc space narrowing and osteophytes are inversely related to vertebral fractures.
Introduction: Although the co-existence of osteoarthritis and osteoporosis is considered as uncommun, it has been suggested that, in post menopausal women, disc space narrowing increases the risk of vertebral fracture. The aim of this study was to check this hypothesis in post menopausal women with osteoporosis.
Patients and methods: The current analysis is based on baseline data collected in a multicenter, prospective and 6 month longitudinal observational study. 410 post menopausal women (74±5 years) consulting for back pain, and having osteoporosis (according to WHO definition), were enrolled. Spine X-rays were performed according to standardized procedures. Vertebral fractures were evaluated from T4 to L4 using the Genant's semi quantitative method; osteoarthritis was evaluated by scoring osteophytes and disc space narrowing at all levels of thoracic and lumbar spine, and by a qualitative assessment of facet joint arthritis.
Results: The prevalence of vertebral fractures was 52.4%. At least one osteophyte, one disc space narrowing and one facet arthritis were present in 90.2, 64.6 and 77.8% of patients respectively. There was an inverse association between vertebral fractures and osteoarthritis: odds ratios adjusted for age and weight (95% CI) were 0.38 (0.17-0.86), p = 0.02 and 0.27 (0.16-0.46), p<10-4 for the presence of at least one osteophyte, and of at least 3 disc space narrowings respectively. In a cluster analysis, it was possible to identify a sub group of patients without any disc space narrowing, and another sub group with all patients having at least one disc space narrowing; the proportion of patients having more than 3 vertebral fractures was 25.2 and 15.9% in these 2 clusters respectively.
Conclusion: In post menopausal women with osteoporosis, disc space narrowing and osteophytes are associated with a decreased vertebral fracture prevalence.
- disc space narrowing
- post menopausal women
- spine osteo arthritis