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Correlation analysis of osteoporotic vertebral compression fractures and spinal sagittal imbalance

Korrelationsanalyse osteoporotischer Wirbelkompressionsfrakturen und des sagittalen Ungleichgewichts der Wirbelsäule

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Abstract

Purpose

To evaluate the correlation between osteoporotic vertebral compression fractures and spinal sagittal imbalance, in order to provide a reference for clinical treatment.

Methods

From September 2013 to March 2015, 60 elderly patients with old osteoporotic vertebral compression factures (observation group) and 60 healthy elderly people (control group) were studied. Whole-spine anteroposterior and lateral view X‑ray photographs were taken from all participants, the number and location of fractured vertebrae were recorded, and sagittal parameters in both groups were compared. The observation group was divided into three subgroups according to the number of fractured vertebrae. The C7/sacrofemoral distance (SFD) ratio in the three subgroups was compared, and the correlation between the number of fractured vertebrae and the C7/SFD ratio was analyzed.

Results

The thoracic kyphotic angle in patients in the observation group was higher than in the control group (P < 0.05), the lumbar lordotic angle in patients in the observation group was lower than in the control group (P < 0.05), the absolute value of the T1 spinopelvic inclination angle in patients in the observation group was lower than in the control group (P < 0.05), and the C7/SFD ratio of patients in the observation group was higher than in the control group (P < 0.05). C7/SFD ratios of the subgroups differed from each other, and the number of fractured vertebrae and C7/SFD ratio were positively correlated.

Conclusion

Osteoporotic vertebral compression fractures can change local spinal sagittal alignment, multiple vertebral compression fractures can cause spinal sagittal imbalance, and the number of fractured vertebrae and the degree of forward movement of the spine were positively correlated.

Zusammenfassung

Ziel der Arbeit

Mit dem Ziel, Hinweise für die klinische Behandlung zu geben, sollte die Korrelation zwischen osteoporotisch bedingten Wirbelkompressionsfrakturen und einem sagittalen Ungleichgewicht der Wirbelsäule untersucht werden.

Methoden

Von September 2013 bis März 2015 wurden 60 ältere Patienten mit alten osteoporotischen Wirbelkompressionsfrakturen (Beobachtungsgruppe) untersucht. Röntgenaufnahmen a.-p. und seitlich wurden bei allen Teilnehmern von der gesamten Wirbelsäule angefertigt, Anzahl und Lokalisation von Wirbelfrakturen dokumentiert und die sagittalen Parameter in beiden Gruppen verglichen. Die Beobachtungsgruppe wurde entsprechend der Anzahl frakturierter Wirbel in 3 Untergruppen aufgeteilt. Der Quotient C7/SFD (sakrofemurale Distanz) wurde in den 3 Untergruppen verglichen und die Korrelation zwischen der Anzahl frakturierter Wirbel und dem C7-SFD-Quotienten ermittelt.

Ergebnisse

Der thorakale Kyphosewinkel war bei den Patienten in der Beobachtungsgruppe größer als in der Kontrollgruppe (p < 0,05), der lumbale Lordosewinkel war bei den Patienten in der Beobachtungsgruppe kleiner als in der Kontrollgruppe (p < 0,05), der absolute Wert des spinopelvinen Neigungswinkels von T1 war bei den Patienten in der Beobachtungsgruppe kleiner als in der Kontrollgruppe (p < 0,05), und der C7-SFD-Quotient war bei den Patienten in der Beobachtungsgruppe größer als in der Kontrollgruppe (p < 0,05). Die C7-SFD-Quotienten der Untergruppen unterschieden sich voneinander, und die Anzahl frakturierter Wirbel war positiv mit dem C7-SFD-Quotienten korreliert.

Schlussfolgerung

Osteoporosebedingte Wirbelkompressionsfrakturen können die lokale sagittale Ausrichtung der Wirbelsäule verändern, mehrere Wirbelkompressionsfrakturen können zu einem sagittalen Ungleichgewicht der Wirbelsäule führen, und die Anzahl frakturierter Wirbel sowie der Grad der Vorneigung der Wirbelsäule waren positiv miteinander korreliert.

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Authors and Affiliations

  1. Department of Spine Surgery, The Affiliated Hospital of Chengde Medical College, 067000, Chengde, China

    Yi-Long Zhang, Li-Tao Shi, Zhi-Jie Sun & Ya-Hui Wang

  2. Department of Orthopaedics, Chinese PLA General Hospital, Medical Scholl of Chinese PLA, No. 28 of Fuxing Road, Haidian District, 100853, Beijing, China

    Pei-Fu Tang

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  1. Yi-Long Zhang
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Correspondence to Pei-Fu Tang.

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Conflict of interest

Y.-L. Zhang, L.-T. Shi, P.-F. Tang, Z.-J. Sun, and Y.-H. Wang declare that they have no competing interests.

A declaration of agreement by an ethical review committee was not necessary to conduct this study.

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Zhang, YL., Shi, LT., Tang, PF. et al. Correlation analysis of osteoporotic vertebral compression fractures and spinal sagittal imbalance. Orthopäde 46, 249–255 (2017). https://doi.org/10.1007/s00132-016-3359-1

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