Quantitative morphologic assessment of thoracolumbar vertebrae in Korean women by morphometric x-ray absorptiometry

To compare the accuracy of lateral radiography of the spine with that of morphometric X-ray absorptiometry(MXA) in vertebral morphometry, and to evaluate normal vertebral morphometry using MXA in Korean women. A spine phantom was constructed using copper pipe. Its anterior and posterior heights were measured directly, with lateral radiographs and with MXA, and the values thus obtained were compared. Inter- and intra-observer variations were evaluated by three radiologists. The vertebral morphometry of 30 young women volunteers were imaged using thoracic and lumbar lateral radiographs and MXA, and analysis included the measurement of anterior and posterior heights from T4 to L4. We also obtained the vertebral morphometry of 200 normal Korean women who underwent MXA between March 1995 and February 1996, though those with osteoporosis and other spinal lesions were excluded from this study. Thoracolumbar vertebral indexes were statistically correlated with age, height and bone mineral density. There were no statistically significant differences in the heights of spine phantom measured by MXA compared with actual size (mean difference=0.28mm). Simple radiographs were magnified by 23.7% at a phantom-table distance of 15cm, and distortion ranged from 0.5% to 22.5%, depending on phantom level and phantom-table distance. In the study of volunteers, the magnification rate between a simple radiograph and MXA was about 26.6%. Anterior height increased progressively from the thoracic to the lumbar spine, though posterior height peaked at L2, and L4 was less than anterior height. In Korean women, indices of vertebral morphometry decreased significantly with aging, with the most prominent decrease occurring during the seventh decade. The mineral density of spinal bone decreased markedly after the sixth decade. Radiographs showed more magnification and distortion than did MXA, though between morphometric X-ray absorptiometry (MXA) and actual size, there was no significant difference. The vertebral morphometric indices of Korean women and referred bone mineral density may provide useful data for determining and evaluating follow-up changes in spinal morphology