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Postoperative change in sagittal balance after Kyphoplasty for the treatment of osteoporotic vertebral compression fracture

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Abstract

Purpose

The influence of vertebral cement augmentation on spinal sagittal balance is unknown. The present study aimed to analyze the changes in total spinal alignment after Kyphoplasty in VCF patients.

Methods

The study involved 21 VCF patients who underwent Kyphoplasty. In all patients, lateral radiographs of the entire spine were taken preoperatively and 1 month after surgery, to measure the pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), sagittal vertical axis (SVA), and spinosacral angle (SSA). These parameters were compared between VCF patients and 30 healthy volunteers. In VCF patients, the parameters were compared before and after Kyphoplasty.

Results

In VCF patients, preoperative SVA was 7.00 ± 3.9 cm, showing a significant shift to anterior sagittal balance as compared to the healthy group (1.45 ± 2.7 cm) (P < 0.0001). Preoperative SS was smaller and PT was larger in VCF group than in the healthy group (P < 0.05). After Kyphoplasty, SVA decreased to 5.02 ± 2.91 (P = 0.0007) and LL and SSA increased (LL P = 0.028; SSA P = 0.0031). Postoperative decrease of SVA was correlated with the kyphotic change of treated vertebra (r = 0.792, P < 0.01). VAS score decreased from 7.98 ± 1.8 before Kyphoplasty to 2.38 ± 2.3 postoperatively (P < 0.0001).

Conclusions

Total spinal alignment is shifted to anterior sagittal balance in VCF patients. Kyphoplasty plays a role not only in reducing pain associated with fractures but also in improving sagittal imbalance in the treatment of painful vertebral compression fracture.

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Abbreviations

VCF:

Vertebral compression fracture

PI:

Pelvic incidence

PT:

Pelvic tilt

SS:

Sacral slope

SSA:

Spinosacral angle

SVA:

Sagittal vertical axis

LL:

Lumbar lordosis

VAS:

Visual analog scale

PMMA:

Polymethylmethacrylate

ADL:

Activities of daily living

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Authors and Affiliations

  1. Department of Neurosurgery, Takeda General Hospital, 28-1, Ishidamoriminami-machi, Fushimi, Kyoto, Kyoto, 601-1495, Japan

    Kunio Yokoyama, Masahiro Kawanishi, Makoto Yamada, Hidekazu Tanaka & Yutaka Ito

  2. Department of Neurosurgery and Department of Surgical Pathology, Osaka Medical College Takatsuki, Osaka, Japan

    Shinji Kawabata & Toshihiko Kuroiwa

Authors
  1. Kunio Yokoyama
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  2. Masahiro Kawanishi
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  3. Makoto Yamada
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  4. Hidekazu Tanaka
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  5. Yutaka Ito
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  6. Shinji Kawabata
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  7. Toshihiko Kuroiwa
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Correspondence to Kunio Yokoyama.

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Yokoyama, K., Kawanishi, M., Yamada, M. et al. Postoperative change in sagittal balance after Kyphoplasty for the treatment of osteoporotic vertebral compression fracture. Eur Spine J 24, 744–749 (2015). https://doi.org/10.1007/s00586-014-3678-z

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  • DOI: https://doi.org/10.1007/s00586-014-3678-z

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