EVOS: Health consequences of vertebral deformities

In the course of the European Vertebral Osteoporosis Study, 16,000 women and men (50-79 years) were examined in 36 European centres. In 8 German centres 4,060 women and men (stratified random samples from population registries) participated in the comprehensive examination programme: Interview, anthropometric measurements and lateral x-rays of the thoracic and lumbar spine. We report on the association of vertebral deformities with subjective health indicators based on the German EVOS-data. Dependent variables were health status, back pain during the last year and today, severity of present back pain (1-10 numerical rating scale), functional capacity (ADL-list, 0-100), grip strength and depression (CES-D, 0-60). The vertebral deformities, identified by three morphometric methods (Eastell -3SD; Eastell -4SD; McCloskey), provided the independent variable. Different sociodemographic variables were controlled for as confounders. Chi-Square tests, multiple and logistic regression analyses were applied. The study shows that back pain among persons with vertebral deformities is as common as among persons without deformities (ORs for men .97/1.28; women 1.15/1.4; the lowest and highest value is shown). Persons with deformities, however, suffer from higher pain severity (difference in men .36/.98; women .49/.68), and they are more restricted in their daily activities (difference in men: -2.49/-6.16; women: -4.62/-7.09). Further, women have a lower grip strength (OR 1.37/1.97) and seem more depressed (OR 1.37/1.97). All associations are more pronounced among women and can be demonstrated for all three deformity definitions. The study suggests a considerable 'public health impact' of vertebral deformities, especially among women.