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Does spinopelvic alignment affect the union status in thoracolumbar osteoporotic vertebral compression fracture?

  • Original Article • SPINE - FRACTURES
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

In the healing of osteoporotic vertebral fracture, global spinal mal-alignment might increase the load sharing at the fracture site and deteriorate the fracture healing. This study aimed to evaluate the effect of spinopelvic alignment on the union status of thoracolumbar osteoporosis-related vertebral compression fracture (OVCF).

Methods

Consecutive 48 patients with a single-level thoracolumbar fresh OVCF were treated non-operatively. Union was judged by three independent observers at 6 months, and patients were divided into union group and non-union group. Spinopelvic alignment was measured using upright whole spine radiograph before treatment as follows: pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), sagittal vertical axis (SVA), and DSVA, defined as the distance from a plumb line dropped from the center of the C7 body to the center of fractured vertebral body.

Result

Global spinal alignment was different in union group and non-union group: SVA (4.7 ± 0.7 cm in union group vs. 8.9 ± 1.3 cm in non-union group, P = 0.007), DSVA (4.2 ± 0.6 cm in union group vs. 9.5 ± 1.0 cm in non-union group, P < 0.001), and PI–LL (18.9° ± 2.2° in union group vs. 30.3° ± 3.9° in non-union group, P = 0.014). Over 5 cm of DSVA [P = 0.022, adjusted odds 7.9 (95 % CI 1.3–77.0)] and/or over 30° of PI–LL [P = 0.026, adjusted odds 6.6 (95 % CI 1.5–44.2)] showed the significant risk factors for non-union using multivariate logistic regression analysis in the other background status.

Conclusions

Global spinal mal-alignment, showing over 5 cm of DSVA and/or over 30° of PI–LL, affected the union status of OVCF.

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Acknowledgments

We would like to express sincere gratitude to our colleagues, nurses, physical therapists, X-ray technicians, pharmacists, and clerks in our hospital who provided effort to the patients. We always thank our families for supporting our work.

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Authors and Affiliations

  1. Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan

    Akira Iwata, Masahiro Kanayama, Fumihiro Oha & Tomoyuki Hashimoto

  2. Department of Orthopaedic Surgery, Hokkaido University School of Medicine, N15 W7 Kita-Ward, Sapporo, Hokkaido, 060-8638, Japan

    Akira Iwata & Norimasa Iwasaki

Authors
  1. Akira Iwata
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  2. Masahiro Kanayama
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Corresponding author

Correspondence to Akira Iwata.

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Conflict of interest

Akira Iwata and Norimasa Iwasaki declare that they have no conflict of interest. Masahiro Kanayama is a member of International Society for the Study of the Lumbar Spine. He has received speaker honorarium from Stryker, Medtronic, Century Medical, Taisho Toyama Pharmaceutical, Otsuka Pharma Inc., Astelas Pharma Inc., Mitsubishi Tanabe Pharma, and Depuy-Synthes. He also has received consultancy from Robert Reid Industry. Fumihiro Oha has received speaker honorarium from Depuy-Synthes. Tomoyuki Hashimoto has received speaker honorarium from Century Medical, Eisai, Taisho Toyama Pharmaceutical, Chugai Pharmaceutical, Asahikasei Pharma, Daiichi Sankyo, and Depuy-Synthes.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Iwata, A., Kanayama, M., Oha, F. et al. Does spinopelvic alignment affect the union status in thoracolumbar osteoporotic vertebral compression fracture?. Eur J Orthop Surg Traumatol 27, 87–92 (2017). https://doi.org/10.1007/s00590-016-1844-1

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  • DOI: https://doi.org/10.1007/s00590-016-1844-1

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