Abstract:Objective To investigate the effect of osteoporotic vertebral compression fracture (OVCF) on the spinopelvic parameters,by comparing OVCF patients and asymptomatic elderly patients.Methods A total of 64 patients (including 22 males and 42 females) with osteoporotic vertebral compression fractures treated in Shougang Hospital from January 2017 to August 2017 were selected.All patients were performed the whole spinal lateral X-ray before operation.During the same period,60 asymptomatic elderly patients were recruited as the control group (20 males and 40 females),and signed the informed consent and performed the whole spinal lateral X-ray.The PACS system was used to measure spinopelvic parameters in 124 cases,including pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),lumbar lordosis(LL),thoracic kyphosis (TK),spinosacral angle (SSA),sagittal vertical axis (SVA),and C7 sagittal ratio (C7/SFD).SPSS20.0 statistical software was used for statistical analysis.Results There was no significant difference in PI between the OVCF group and the control group.The SS,LL,and SSA of the OVCF group were (31.23±8.88)°,(45.48±12.59)°,and (118.01±9.61)°,respectively,which were significantly smaller than those in the control group (P<0.01).The PT,TK,SVA,and C7/SFD in the OVCF group were (19.75±10.46)°,(41.98±11.86)°,(34.72±40.72)mm,and (0.75±1.04),respectively,which were significantly greater than those in the control group (P<0.05).The sagittal imbalance ratios of SVA and C7/SFD in the OVCF group were 33.4% and 59.4%,respectively,which were significantly higher than those in the control group (P<0.01).Conclusion Osteoporotic compression vertebral fractures (OVCF) can reduce LL,SS,SSA,and increase TK,PT,SVA,C7/SFD,which is prone to spinopelvic sagittal imbalance.Spinal deformity Surgery should be performed to restore sagittal balance.
[1]Brown C.Osteoporosis:Staying strong[J].Nature,2017,550(7674):S15-S17.
[2]Hwang JS,Chan DC,Chen JF,et al.Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan:summary[J].J Bone Miner Metab,2014,32(1):10-16.
[3]Kanis JA.Diagnosis of osteoporosis and assessment of fracture risk[J].Lancet,2002,359(9321):1929-1936.
[4]Johnell O,Kanis JA.An estimate of the worldwide prevalence and disability associated with osteoporotic fractures[J].Osteoporos Int,2006,17(12):1726-1733.
[5]Li B,Sun C,Zhao C,et al.Epidemiological profile of thoracolumbar fracture (TLF) over a period of 10 years in Tianjin,China[J].J Spinal Cord Med,2019,42(2):178-183.
[6]Zhou J,Qin MZ,Liu Q,et al.Investigation and analysis of osteoporosis,falls,and fragility fractures in elderly people in the Beijing area:a study on the bone health status of elderly people ≥80 years old with life selfcare[J].Arch Osteoporos,2017,12(1):108.
[7]Diebo BG,Varghese JJ,Lafage R,et al.Sagittal alignment of the spine:What do you need to know?[J].Clin Neurol Neurosurg,2015(139):295-301.
[8]Jackson RP,Kanemura T,Kawakami N,et al.Lumbopelvic lordosis and pelvic balance on repeated standing lateral radiographs of adult volunteers and untreated patients with constant low back pain[J].Spine (Phila Pa 1976),2000,25(5):575-586.
[9]Roussouly P,Gollogly S,Berthonnaud E,et al.Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position[J].Spine (Phila Pa 1976),2005,30(3):346-353.
[10]Berthonnaud E,Dimnet J,Roussouly P,et al.Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters[J].J Spinal Disord Tech,2005,18(1):40-47.
[11]Boulay C,Tardieu C,Hecquet J,et al.Sagittal alignment of spine and pelvis regulated by pelvic incidence:standard values and prediction of lordosis[J].Eur Spine J,2006,15(4):415-422.
[12]Lafage V,Schwab F,Patel A,et al.Pelvic tilt and truncal inclination:two key radiographic parameters in the setting of adults with spinal deformity[J].Spine (Phila Pa 1976),2009,34(17):E599-606.
[13]Vialle R,Levassor N,Rillardon L,et al.Radiographic analysis of the sagittal alignment and balance of the spine in asymptomatic subjects[J].J Bone Joint Surg (Am),2005,87(2):260-267.
[14]Fechtenbaum J,Etcheto A,Kolta S,et al.Sagittal balance of the spine in patients with osteoporotic vertebral fractures[J].Osteoporos Int,2016,27(2):559-567.
[15]Dai J,Yu X,Huang S,et al.Relationship between sagittal spinal alignment and the incidence of vertebral fracture in menopausal women with osteoporosis:a multicenter longitudinal followup study[J].Eur Spine J,2015,24(4):737-743.
[16]Bouaicha S,Cunier M,Scheyerer MJ,et al.Does sagittal spinopelvic configuration influence vertebral fracture type or localization in trauma patients?:A Retrospective radiologic analysis[J].Clin Spine Surg,2017,30(3):E265-E269.
[17]Legaye J,Duval-Beaupere G,Hecquet J,et al.Pelvic incidence:a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves[J].Eur Spine J,1998,7(2):99-103.
[18]Schwab F,Lafage V,Patel A,et al.Sagittal plane considerations and the pelvis in the adult patient[J].Spine (Phila Pa 1976),2009,34(17):1828-1833.
[19]Blondel B,Schwab F,Ungar B,et al.Impact of magnitude and percentage of global sagittal plane correction on health-related quality of life at 2-years follow-up[J].Neurosurgery,2012,71(2):341-348.
[20]Li YX,Guo DQ,Zhang SC,et al.Risk factor analysis for re-collapse of cemented vertebrae after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP)[J].Int Orthop,2018,42(9):2131-2139.