[Vertebral fractures--a big health problem for elderly women?].
BACKGROUND
The term osteoporosis often conjures up an image of deformed spines,--small stooping ladies burdened with back pain. Most modern medication against osteoporosis has documented effect first and foremost against vertebral fractures. However, are vertebral fractures a public health issue, and are they frequent and serious enough to warrant aggressive and expensive preventive measures?


METHODS
Through search in Medline with the terms "osteoporosis", "vertebral fracture*" and "vertebral deformities", we identified and reviewed a total of 222 scientific articles on vertebral fractures.


RESULTS
Incident vertebral deformities entail temporary complaints, and the consequences of prevalent deformities are minute unless there are several deformities. Less than 8% of back pain among the elderly can be attributed to vertebral deformities. A large double-blind, randomised clinical trial demonstrates that treatment that halves the risk of new vertebral deformities barely affects the occurrence of back pain or disability.


CONCLUSIONS
Even if some patients' suffering is attributable to vertebral deformities, we conclude that vertebral deformities represent a minor public health problem. As a consequence, studies exploring predictors of painful vertebral fractures are warranted; furthermore, more documentation on prevention of non-vertebral fractures is needed.
Joakimsen
R M
RM
Seksjon for forebyggende medisin, Institutt for samfunnsmedisin, Universitetet i Tromsø, 9037 Tromsø. Ragnar.Joakimsen@ism.uit.no
Berntsen
G K
GK
Fønnebø
V
V
D000368:Aged; D001416:Back Pain / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008488:Medical Illustration; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000517:prevention & control; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology; D016387:Women's Health