Zhang Yi-Long, Shi Li-Tao, Tang Pei-Fu, Sun Zhi-Jie, Wang Ya-Hui
Department of Spine Surgery, The Affiliated Hospital of Chengde Medical College, 067000, Chengde, China.
Department of Orthopaedics, Chinese PLA General Hospital, Medical Scholl of Chinese PLA, No. 28 of Fuxing Road, Haidian District, 100853, Beijing, China.
Orthopade. 2017 Mar;46(3):249-255. doi: 10.1007/s00132-016-3359-1.
To evaluate the correlation between osteoporotic vertebral compression fractures and spinal sagittal imbalance, in order to provide a reference for clinical treatment.
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.
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.
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.
评估骨质疏松性椎体压缩骨折与脊柱矢状面失衡之间的相关性,为临床治疗提供参考。
选取2013年9月至2015年3月期间60例老年骨质疏松性椎体压缩骨折患者(观察组)和60例健康老年人(对照组)进行研究。对所有参与者拍摄全脊柱正侧位X线片,记录骨折椎体的数量和位置,并比较两组的矢状面参数。观察组根据骨折椎体数量分为三个亚组。比较三个亚组的C7/骶股距离(SFD)比值,分析骨折椎体数量与C7/SFD比值之间的相关性。
观察组患者的胸椎后凸角高于对照组(P<0.05),观察组患者的腰椎前凸角低于对照组(P<0.05),观察组患者的T1脊柱骨盆倾斜角绝对值低于对照组(P<0.05),观察组患者的C7/SFD比值高于对照组(P<0.05)。各亚组的C7/SFD比值不同,骨折椎体数量与C7/SFD比值呈正相关。
骨质疏松性椎体压缩骨折可改变局部脊柱矢状面排列,多发性椎体压缩骨折可导致脊柱矢状面失衡,骨折椎体数量与脊柱前凸程度呈正相关。