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The relationship between the spinopelvic balance and the incidence of adjacent vertebral fractures following percutaneous vertebroplasty

Osteoporosis International volume 26, pages 1507–1513 (2015)Cite this article

Abstract

Summary

We evaluated the relationship between sagittal spinopelvic parameters and the occurrence of adjacent vertebral fractures (AVF) and determined the possible risk factor. The most important factors for AVFs are the degree of osteoporosis and altered biomechanics due to the spinopelvic imbalance in the fractured area of the spine.

Introduction

We intend to evaluate the relationship between sagittal spinopelvic parameters and the occurrence of adjacent vertebral fractures following the initial compression fracture and to determine the possible dominant risk factor associated with new compression fractures.

Methods

From March 2010 to May 2012, 240 consecutive patients with painful vertebral compression fractures (VCFs) were enrolled in a retrospective study. Ninety-one patients with VCFs underwent percutaneous vertebroplasty (VP) at 112 levels. The sagittal vertical axis (SVA), thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and segmental kyphotic angle on sagittal standing radiographs were used to evaluate radiologic outcomes.

Results

In 2 years, 15 out of 134 patients (11.1 %) treated with conservative treatment, and 12 out of 91 patients (13.1 %) treated with VP sustained adjacent level fracture. More patients with the BMD higher or equal to 3.0 experienced a new fracture than those with a BMD less than 3.0 (p = 0.019), and the risk for adjacent level fractures decreased significantly when segmental kyphotic angle was less than 11° (p = 0.001), SVA was less than 6 cm (p = 0.001), SS was higher or equal to 25° (p = 0.004), and LL was higher or equal to 25° (p = 0.020).

Conclusions

The most important factors for new VCFs after the initial compression fractures are the degree of osteoporosis and altered biomechanics due to the spinopelvic imbalance in the fractured area of the spine. Regarding the spinopelvic alignment to investigate the relationship with a subsequent AVF, segmental kyphotic angle, SS, LL, and SVA may be a potential predictor.

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Conflicts of Interest

None. The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Affiliations

  1. Department of Orthopaedic Surgery, Spine Center, Busan Korea Hospital, Busan, Korea

    S.-W. Baek, C. Kim & H. Chang

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  1. S.-W. Baek
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  2. C. Kim
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  3. H. Chang
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Correspondence to S.-W. Baek.

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Baek, SW., Kim, C. & Chang, H. The relationship between the spinopelvic balance and the incidence of adjacent vertebral fractures following percutaneous vertebroplasty. Osteoporos Int 26, 1507–1513 (2015). https://doi.org/10.1007/s00198-014-3021-x

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  • DOI: https://doi.org/10.1007/s00198-014-3021-x

Keywords

  • Adjacent vertebral fracture
  • Osteoporotic compression fracture
  • Percutaneous vertebroplasty
  • Spinopelvic balance