title: The spinal curvature irregularity index independently identifies vertebral fractures.
abstract: OBJECTIVE
  The spinal curvature irregularity index (SCII) is a quantitative measure of the irregularity of the spinal curvature. We evaluated the predictive ability of SCII to identify subjects with vertebral fractures (VF).
  
  
  METHODS
  Vertebral heights were measured by quantitative vertebral morphometry in 461 Lebanese women 20-89 years of age and VFs were ascertained by the grade 1 Eastell method. SCII scores were log-transformed and expressed as Z-SCII, the number of standard deviations above or below the mean ln(SCII) of young patients without VF. Univariate and multivariate binary logistic regression models were used to identify clinical predictors of VF.
  
  
  RESULTS
  Women with a higher SCII were more likely to have prevalent VF. A higher SCII was associated with a greater prevalence of VF within each category of femoral neck BMD (normal, osteopenia, osteoporosis). In univariate analysis, predictors of VF included Z-SCII (odds ratio, OR: 2.21, 95% CI: 1.80-2.71) and femoral neck T-score (OR: 1.35, 95% CI: 1.12-1.63). In multivariate analysis, predictors of VF were: Z-SCII (OR: 1.54, 95% CI: 1.02-2.32), femoral neck T-score (OR: 1.41, 95% CI: 1.11-1.78) and age(3) (OR: 1.40, 95% CI 1.10-1.82). At a cutoff SCII of 9.5%, the sensitivity and specificity of SCII for VF were 71 and 64% respectively, and higher SCII cutoffs identified VFs with greater specificity.
  
  
  CONCLUSIONS
  The SCII is a robust, simple and independent indicator of the presence of VFs.
authors.affiliation: Department of Orthopaedics, St George Hospital, P.O. Box 166378, Achrafieh-Beirut 11002807, Lebanon.
authors.forename: G
authors.initials: G
authors.lastname: Maalouf
authors.forename: N M
authors.initials: NM
authors.lastname: Maalouf
authors.forename: N
authors.initials: N
authors.lastname: Schaaf
authors.forename: R M
authors.initials: RM
authors.lastname: Zebaze
authors.forename: A
authors.initials: A
authors.lastname: Nehme
authors.forename: Z
authors.initials: Z
authors.lastname: Tannous
authors.forename: J
authors.initials: J
authors.lastname: Wehbe
authors.forename: G
authors.initials: G
authors.lastname: Adib
authors.forename: M-H
authors.initials: MH
authors.lastname: Gannagé-Yared
authors.forename: E
authors.initials: E
authors.lastname: Seeman
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry / Q000379:methods; D015519:Bone Density; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008875:Middle Aged; D009043:Motor Activity; D010024:Osteoporosis / Q000150:complications / Q000503:physiopathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013121:Spinal Curvatures / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D016103:Spinal Fractures / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology