Highlights
- •Higher lumbar BMD was associated with more severe disc degeneration.
- •There was no significant association between femoral neck BMD and disc degeneration.
- •Degenerative changes may falsely increase the BMD values in the lumbar spine.
- •Lumbar spine BMD may not be a good indicator of osteoporosis for elderly.
- •Femoral neck BMD may be more reliable than lumbar BMD in postmenopausal women.
Abstract
Objectives
Higher vertebral bone mineral density (BMD) has been found to be related with lumbar
disc degeneration (LDD), while relationship between femoral neck BMD and LDD remains
controversial. The aim of our research was to study the relationship between LDD and
BMD of the lumbar spine and femoral neck.
Study design
The study population consisted of 168 postmenopausal women (aged 63.3–75.0 years,
mean 68.6 years) from the prospective OSTPRE and OSTPRE-FPS study cohorts. The severity
of LDD was graded from T2-weighted MRI images using the five-grade Pfirrmann classification.
Four vertebral levels (L1-L4) were studied (total 672 discs). The association between
lumbar BMD and Z-score and the severity of LDD was studied separately for each vertebral level with
AN(C)OVA analysis, using potential confounders as covariates.
Results
Higher lumbar BMD and Z-score were associated with more severe LDD at all studied levels (L1-L4): between
L4-L5 disc and L4 BMD (p = 0.044) and L4 Z-score (p = 0.052), between L2-L3 disc and L3 BMD (p = 0.001) and at all other levels (p < 0.001). The mean degeneration grade of the studied discs was associated with the mean
L1-L4 BMD and Z-score (p < 0.001). Statistical significance of any result did not alter after controlling for
confounding factors. There was no significant association between femoral neck BMD
and LDD.
Conclusions
Higher lumbar BMD/Z-score were associated with more severe LDD. There was no significant association
between femoral neck BMD and disc degeneration. Femoral neck BMD may be a more reliable
measurement for diagnosing osteoporosis in postmenopausal women with degenerative
changes in the lumbar spine.
Keywords
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Article info
Publication history
Published online: September 20, 2014
Accepted:
September 15,
2014
Received in revised form:
September 14,
2014
Received:
June 8,
2014
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
