TY - JOUR
TI - Back pain, disability, and radiographic vertebral fracture in European
women: a prospective study
AU - O'Neill, TW
AU - Cockerill, W
AU - Matthis, C
AU - Raspe, HH
AU - Lunt, M
AU - and Cooper, C
AU - Banzer, D
AU - Cannata, JB
AU - Naves, M
AU - Felsch, B
AU - and Felsenberg, D
AU - Janott, J
AU - Johnell, O
AU - Kanis, JA
AU - Kragl,
AU - G
AU - Vaz, AL
AU - Lyritis, G
AU - Masaryk, P
AU - Poor, G
AU - Reid, DM and
AU - Reisinger, W
AU - Scheidt-Nave, C
AU - Stepan, JJ
AU - Todd, CJ
AU - Woolf,
AU - AD
AU - Reeve, J
AU - Silman, AJ
JO - Osteoporosis International
PY - 2004
VL - 15
TODO - 9
SP - 760-765
PB - Springer-Verlag London Ltd
SN - 0937-941X, 1433-2965
TODO - 10.1007/s00198-004-1615-4
TODO - back pain; disability; prospective study; vertebral fracture
TODO - Vertebral fractures are associated with back pain and disability. There
are, however, few prospective data looking at back pain and disability
following identification of radiographic vertebral fracture. The aim of
this analysis was to determine the impact of radiographically identified
vertebral fracture on the subsequent occurrence of back pain and
disability. Women aged 50 years and over were recruited from population
registers in 18 European centers for participation in the European
Prospective Osteoporosis Study. Participants completed an
interviewer-administered questionnaire which included questions about
back pain in the past year and various activities of daily living, and
they had lateral spine radiographs performed. Participants in these
centers were followed prospectively and had repeat spine radiographs
performed a mean of 3.7 years later. In addition they completed a
questionnaire with the same baseline questions concerning back pain and
activities of daily living. The presence of prevalent and incident
vertebral fracture was defined using established morphometric criteria.
The data were analyzed using logistic regression with back pain or
disability (present or absent) at follow-up as the outcome variable with
adjustment made for the baseline value of the variable. The study
included 2,260 women, mean age 62.2 years. The mean time between
baseline and follow-up survey was 5.0 years. Two hundred and forty
participants had prevalent fractures at the baseline survey, and 85
developed incident fractures during follow-up. After adjustment for age,
center, and the baseline level of disability, compared with those
without baseline prevalent fracture, those with a prevalent fracture
(odds ratio [OR]=1.4; 95% confidence interval [CI] 1.0 to 2.0) or
an incident fracture (OR=1.7; 95% CI, 0.9 to 3.2) were more likely to
report disability at follow-up, though the confidence intervals embraced
unity. Those with both a prevalent and incident fracture, however, were
significantly more likely to report disability at follow-up (OR=3.1;
95% CI, 1.4 to 7.0). After adjustment for age, center, and frequency of
back pain at baseline, compared with those without baseline vertebral
fracture, those with a prevalent fracture were no more likely to report
back pain at follow-up (OR=1.2; 95%CI, 0.8 to 1.7). There was a small
increased risk among those with a preexisting fracture who had sustained
an incident fracture during follow-up (OR=1.6; 95%CI, 0.6 to 4.1)
though the confidence intervals embraced unity. In conclusion, although
there was no significant increase in the level of back pain an average
of 5 years following identification of radiographic vertebral fracture,
women who suffered a further fracture during follow-up experienced
substantial levels of disability with impairment in key physical
functions of independent living.
ER -