An examination of the association between vertebral deformities, physical disabilities and psychosocial problems.
In order to measure the clinical consequences of spinal osteoporosis, we correlated a number of physical and psychosocial dysfunctions with the degree of vertebral deformity in 204 women aged 55-75 yr. We employed 5 standardized questionnaire instruments: the physical dimension of the Sickness Impact Profile (SIP), an analog back pain scale, a 24-question instrument eliciting back-related disabilities, and assessments of self-esteem and mastery. Using these results as the dependent variables, we performed 5 separate stepwise regression analyses; independent variables were vertebral deformity score and 11 possible confounders. Using Pearson correlation coefficients, we found a high degree of correlation between each of the 5 primary outcome variables. Vertebral deformity score played a small but statistically significant role in the 3 models whose dependent variable was related to physical dysfunction, but it accounted for only 4-10% of the variance of these models. Mastery and self-esteem were related to overall poor health and attendant physical disabilities but not to vertebral deformity score. In this selected cohort of women, the occurrence of mild to moderate vertebral deformities caused little loss of physical function or function of psychosocial problems because of vertebral deformity. Although we were able to demonstrate a statistically significant handicap related to the total vertebral deformity score, several other clinical variables appeared to have a greater impact.
Ettinger
B
B
Department of Medicine, Kaiser Permanente Medical Center, San Francisco, CA.
Block
J E
JE
Smith
R
R
Cummings
S R
SR
Harris
S T
ST
Genant
H K
HK
D000368:Aged; D001416:Back Pain / Q000209:etiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000523:psychology; D011859:Radiography; D012649:Self Concept; D013122:Spinal Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000523:psychology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging