Vertebral Scheuermann’s disease in Europe prevale

Authors: G Armbrecht D Felsenberg M Ganswindt M Lunt S K Kaptoge K Abendroth A Aroso D Banzer A K Bhalla J Dequeker R Eastell K Hoszowski G Lyritis P D Delmas P Masaryk T Miazgowski J Cannata R Nuti L Oei G Poor I RedlundJohnell D M Reid W Reisinger H Schatz C J Todd A D Woolf K Javaid F Rivadeneira A J Silman C Cooper T W O’Neill J Reeve On behalf of the European Vertebral Osteoporosis Study EVOS and European Prospective Osteoporosis Study EPOS Groups

Publish Date: 2015/05/29

Volume: 26, Issue: 10, Pages: 2509-2519

PDF Link

Abstract

In 27 centres across Europe the prevalence of deforming spinal Scheuermann’s disease in agestratified populationbased samples of over 10000 men and women aged 50+ averaged 8  in each sex but was highly variable between centres Low DXA BMD was unassociated with Scheuermann’s helping the differential diagnosis from osteoporosisThis study aims to assess the prevalence of Scheuermann’s disease of the spine across Europe in men and women over 50 years of age to quantitate its association with bone mineral density BMD and to assess its role as a confounder for the radiographic diagnosis of osteoporotic fractureIn 27 centres participating in the populationbased European Vertebral Osteoporosis Study EVOS standardised lateral radiographs of the lumbar and of the thoracic spine from T4 to L4 were assessed in all those of adequate quality The presence of Scheuermann’s disease a confounder for prevalent fracture in later life was defined by the presence of at least one Schmorl’s node or irregular endplate together with kyphosis sagittal Cobb angle 40° between T4 and T12 or a wedgedshaped vertebral body Alternatively the rare EdgrenVaino sign was taken as diagnostic The 6pointpervertebralbody 13 vertebrae method was used to assess osteoporotic vertebral shape and fracture caseness DXA BMD of the L2–L4 and femoral neck regions was measured in subsets We also assessed the presence of Scheuermann’s by alternative published algorithms when these used the radiographic signs we assessedVertebral radiographic images from 4486 men and 5655 women passed all quality checks Prevalence of Scheuermann’s varied considerably between centres and based on random effect modelling the overall European prevalence using our method was 8  with no significant difference between sexes The highest prevalences were seen in Germany Sweden the UK and France and low prevalences were seen in Hungary Poland and Slovakia Centrelevel prevalences in men and women were highly correlated Scheuermann’s was not associated with BMD of the spine or hipPrincipal Investigators of the centres participating in both the EVOS and EPOS Study Groups Aberdeen UK—Reid DM Athens Greece—Lyritis G Bath UK—Bhalla AK Berlin Germany—Felsenberg D Banzer D Reisinger W Bochum Germany—Schatz H Budapest Hungary—Poor G Cambridgeshire UK—Todd CJ Erfurt Germany—Kragl G Graz Austria—Weber K Harrow UK—Reeve J Heidelberg Germany—ScheidtNave C Jena Germany—Abendroth K Leuven Belgium—Dequeker J Lyon France—Delmas PD Lübeck Germany—Raspe H Malmö Sweden—Johnell O Manchester UK—O’Neill TW Moscow Russia—Benevolenskaya L Oporto Portugal—Aroso A Oviedo Spain—Cannata J Piestany Slovakia—Masaryk P Prague Czech Republic—Havelka S Rotterdam Netherlands—Pols H Siena Italy—Nuti R Szczecin Poland—Miazgowski T Truro UK—Woolf AD Warsaw Poland—Hoszowski K Yaroslavl Russia—Yershova O Zagreb Croatia—Jajic IThe acquisition of the images for this study was financially supported by a European Union Concerted Action Grant under BIOMED 1 BMH1CT920182 and also EU grants C1PDCT925102 ERBC1PDCT 930105 and 940229 The central coordination for the data acquisition phase was also supported by the UK Arthritis Research Campaign the Medical Research Council G9321536 and the European Foundation for Osteoporosis and Bone Disease The EU’s PECO program linked to BIOMED 1 funded in part the participation of the Budapest Warsaw Prague Piestany Szczecin and Moscow centres The central xray evaluation for vertebral fracture was sponsored by the Bundesministerium fur Forschung and Technologie Germany The xray evaluation for other radiological aspects of this study was undertaken as part of a PhD studentship to MG and otherwise it was undertaken without external financial support JR CC and KJ acknowledge the support of the NIHR to the Biomedical Research Unit in Musculoskeletal Disease at the Botnar Research Centre Oxford Individual centres acknowledge the receipt of locally acquired support for their data collection We thank the thousands of individuals who took part in the study and the many other individuals who helped access our population samples

Keywords: