Factors Predicting the Surgical Risk of Osteoporotic Vertebral Compression Fractures.

Fu-Cheng Kao,Yu-Jui Huang,Tsung-Ting Tsai,Ming-Kai Hsieh,Ping-Yeh Chiu

doi:10.3390/jcm8040501

Abstract

The aim of our study was to investigate the association between global spinal alignment, spinopelvic parameters, and outcomes of osteoporotic vertebral compression fractures (OVCF). Patients with vertebral compression fractures seen at our hospital between October 2017 and November of 2018 with a bone mineral density (BMD) T-score < −2.5 were recruited for the study. Surgical intervention was performed after eight weeks of conservative treatment depending on clinical symptoms and the willingness of patients. Spinopelvic and sagittal alignment parameters were compared between patients who had surgery and those that did not. Seventy-nine patients were included in the study. Twenty-five patients (31.6%, mean age: 73.28 ± 9.78 years) received surgery, and 54 (68.3%, mean age: 73 ± 8.58 years) conservative treatment only. Pelvic tilt, pelvic incidence, and local kyphotic angle were statistically different between the groups (all p < 0.05). A sagittal vertical axis ≥ 50 mm, distance between the C7 plumb line and the center of the fractured vertebra (DSVA) ≥ 60 mm, pelvic incidence outside of the range of 44 to 62°), and pelvic tilt ≥ 27° were associted with the need for surgical intervention. Measurement of spinopelvic parameters can predict the need for surgery in patients with OVCF.

Highlights

OVCFs occur spontaneously, or, more commonly, occur as a result of minimal trauma from day-to-day activities, such as bending forward, twisting, lifting objects, and even sitting from a standing position onto a low chair [1]
The aim of this study was to investigate the association between global spinal alignment, spinopelvic parameters, and outcomes of OVCFs in order to predict the response to nonsurgical treatment of OVCFs
Patients with vertebral compression fractures seen at our hospital between October 2017 and November of 2018 with a bone mineral density (BMD) T-score < −2.5 were recruited for this prospective study

Summary

Introduction

OVCFs occur spontaneously, or, more commonly, occur as a result of minimal trauma from day-to-day activities, such as bending forward, twisting, lifting objects, and even sitting from a standing position onto a low chair [1] They are a common cause of morbidity, and are the most common fragility fractures in postmenopausal women. Trunk imbalance leads to considerable muscular demand, fatigue, and back pain, as well as disability [12] Spinopelvic parameters, such as sagittal vertical axis (SVA), pelvic incidence (PI), sacral slope (SS), and lumbar lordosis (LL), can assist in assessing spinal alignment. The aim of this study was to investigate the association between global spinal alignment, spinopelvic parameters, and outcomes of OVCFs in order to predict the response to nonsurgical treatment of OVCFs

Experimental Section

Spinopelvic Parameters and Sagittal Alignment

Prediction of Risk of Surgical Intervention

Findings

Conclusions