ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2013
Degenerative changes at the lumbar spine--implications for bone mineral density measurement in elderly women.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 6 of them syntheses that pooled it.
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86 citing papers in PubMed, 6 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Generation and validation of a Hounsfield unit (HU) threshold for predicting mechanical and junctional complications following thoracolumbar or lumbar fusion: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Pooled it
- Association between bone mineral density and coronary artery calcification: an updated systematic review and meta-analysis.BMC cardiovascular disorders · 2026Pooled it
- The correlation between bone mineral density measured at the forearm and at the lumbar spine or femoral neck: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- Exploring mean kurtosis in MR diffusion kurtosis imaging for early detection of lumbar spine degeneration: a systematic review.F1000Research · 2025Pooled it
- Association between trabecular bone score and type 2 diabetes: a quantitative update of evidence.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Pooled it
- Life-Course Genome-wide Association Study Meta-analysis of Total Body BMD and Assessment of Age-Specific Effects.American journal of human genetics · 2018Pooled it
- Article title efficacy and safety of romosozumab in postmenopausal women with osteoporosis previously treated with antiresorptive drugs: a prospective observational study and literature review.Frontiers in global women's health · 2026Trial
- Accelerated bone loss increases osteoporosis and fracture risk in moderate to severe chronic kidney disease.Renal failure · 2026Article
- Development and evaluation of a simple CT-based DXA triage score for osteoporosis in candidates for lumbar spine surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Performance of screening tools for osteoporosis and fractures in community-dwelling elderly Japanese men.Journal of bone and mineral metabolism · 2026Article
- Artificial Intelligence-Driven Precision Bisphosphonate Therapy in Osteoporosis: Mechanisms, Clinical Applications, Risks, and Future Directions.Orthopaedic surgery · 2026Review
- An interpretable machine learning model integrating ultrasound and clinical variables for predicting osteoporosis in patients with rheumatoid arthritis.Clinical rheumatology · 2026Article
- Thoracolumbar vertebral bone quality (TLVBQ) score as a possible screening tool for osteoporosis in patients with severe degenerative lumbar scoliosis: a retrospective cohort study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Trabecular bone score beyond bone mineral density for identifying osteoporotic vertebral compression fractures: a matched case-control study.Asian spine journal · 2026Article
- Streamlining the MRI-Derived Vertebral Bone Quality Score for Preoperative Osteoporosis and Osteopenia Screening.Global spine journal · 2026Article
- Key determinants for lowering the risk of joint replacement in weight-bearing joints: a population-based cohort study.Arthroplasty (London, England) · 2026Article
- Discordance in bone mineral density between lumbar spine and hip in patients with rheumatoid arthritis: A cross-sectional study.Osteoporosis and sarcopenia · 2026Article
- Differences in lumbar spine bone mineral density measured by quantitative computed tomography and dual-energy X-ray absorptiometry: an age- and sex-specific analysis.Journal of orthopaedic surgery and research · 2026Article
- High prevalence of sarcopenia, osteoporosis and osteosarcopenia in patients with chronic kidney disease compared with healthy controls.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Comment on "Loss of muscle and bone mass with increased adiposity and fractures in patients with chronic obstructive pulmonary disease: a 5-year follow-up cohort study" (Osteoporosis International, 2025).Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
26 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
unlabelledDegenerative changes of the lumbar spine may lead to misinterpretation of bone mineral density (BMD) measurements and cause underdiagnosis of osteoporosis. This longitudinal study of 1,044 women, 75 years at inclusion and followed for 10 years, shows that identification of apparent degenerative changes on the dual energy X-ray absorptiometry (DXA) scan can increase the proportion diagnosed.
introductionIn the elderly, degenerative manifestations in the lumbar spine may result in falsely elevated BMD values, consequently missing a large proportion of those with osteoporosis. Our aim was to determine the distribution and impact of degenerative changes on lumbar spine DXA over time and its clinical implications.
methodsParticipants were 1,044 women from the population-based Osteoporosis Risk Assessment cohort. All women were 75 years old at invitation and followed up after 5 years (n=715) and 10 years (n=382). Degenerative changes were evaluated visually on the DXA image for each vertebra L1 to L4 (intraobserver precision kappa values of 0.66-0.70).
resultsAt baseline, apparent degenerative changes were more frequent in the inferior segments of the lumbar spine [5% (L1), 15% (L2), 26% (L3), and 36% (L4)] and increased over time. At 10 years, the prevalences were 20% (L1), 39% (L2), 59% (L3), 72% (L4), resulting in a significant increase in overall BMD. In women without apparent degenerative changes, BMD remained stable between 75 and 85 rather than an expected bone loss. At baseline, 37% had osteoporosis (BMD<-2.5) at L1-L4; exclusion of women with apparent degenerative changes increased this proportion to 47%. Using L1-L2, which was less prone to degenerative changes, 46% of women were classified as osteoporotic regardless of degenerative changes.
conclusionDegenerative changes were very common in elderly women, accelerated disproportionately over time, were increasingly frequent from vertebrae L1 to L4, and had significant impact on diagnosing osteoporosis. This suggests that routine reporting of spine BMD at L1-L2 would add valuable information for reassessment and monitoring.
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