Diffuse idiopathic skeletal hyperostosis association with thoracic spine kyphosis: a cross-sectional study for the Health Aging and Body Composition Study.
METHODS
A descriptive study of the association between diffuse idiopathic skeletal hyperostosis (DISH) and kyphosis.


OBJECTIVE
To investigate the association of DISH with Cobb angle of kyphosis in a large cohort of older subjects from the Health Aging and Body Composition Study.


BACKGROUND
DISH and thoracic kyphosis are well-defined radiographical findings in spines of older individuals. Characteristics of DISH (ossifications between vertebral segments) reflect changes of spine anatomy and physiology that may be associated with Cobb angle of kyphosis.


METHODS
Using data from 1172 subjects aged 70 to 79 years, we measured DISH and Cobb angle of kyphosis from computed tomographic lateral scout scans. Characteristics of participants with and without DISH were assessed using the χ² and t tests. Association between DISH and Cobb angle was analyzed using linear regression. Cobb angle and DISH relationship was assessed at different spine levels (thoracic and lumbar).


RESULTS
DISH was identified on computed tomographic scout scan in 152 subjects with 101 cases in only the thoracic spine and 51 in both thoracic and lumbar spine segments. The mean Cobb angle of kyphosis in the analytic sample was 31.3° (standard deviation = 11.2). The presence of DISH was associated with a greater Cobb angle of 9.1° and 95% confidence interval (95% CI) (5.6-12.6) among African Americans and a Cobb angle of 2.9° and 95% CI (0.5-5.2) among Caucasians compared with those with no DISH. DISH in the thoracic spine alone was associated with a greater Cobb angle of 10.6° and 95% CI (6.5-14.7) in African Americans and a Cobb angle of 3.8° and 95% CI (1.0-6.5) in Caucasians compared with those with no DISH.


CONCLUSIONS
DISH is associated with greater Cobb angle of kyphosis, especially when present in the thoracic spine alone. The association of DISH with Cobb angle is stronger within the African American population.
*Department of Radiology, University of California San Francisco, San Francisco, CA †Center for Musculoskeletal Health, University of California at Davis School of Medicine, Sacramento, CA ‡California Pacific Medical Research Center, San Francisco, CA §Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA ¶Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA ‖Department of Physical Therapy, College of Allied Health Sciences, The University of Tennessee Health Science Center, Memphis, TN **Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, Bethesda, MD; and ††Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA.
Lorenzo
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Nardo
Nancy E
NE
Lane
Neeta
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Parimi
Peggy M
PM
Cawthon
Bo
B
Fan
John
J
Shepherd
Jane
J
Cauley
Audrey
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Zucker-Levin
Rachel A
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Murphy
Wendy B
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Katzman
D001741:Black or African American; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D004057:Hyperostosis, Diffuse Idiopathic Skeletal / Q000150:complications* / Q000000981:diagnostic imaging* / Q000208:ethnology; D007738:Kyphosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000208:ethnology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D044465:White People