Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu, Shizuoka, Japan.
Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan.
Spine (Phila Pa 1976). 2020 Oct 1;45(19):E1232-E1238. doi: 10.1097/BRS.0000000000003534.
Four-year, longitudinal cohort study.
The aim of this study was to investigate the effect of original spinal shape on incidental vertebral fractures (VFs) and to identify the influence of changes in pre- and post-fracture geometrical spinal shape.
Clinical evidence demonstrates that VFs cause spinal kyphosis, morbidities, and deteriorating quality of life in elderly people. However, knowledge of geometrical spinal shapes that affect incidental VFs is limited.
Three hundred seventeen volunteers underwent whole spine radiography as part of a health screening in both 2012 and 2016. We extracted volunteers with incidental VF in 2016. Sex- and age-matched volunteers without VF were enrolled as controls. Baseline demographic variables, geometrical spinal shape, and spinopelvic parameters were compared between the two groups. In volunteers with incidental VF, we investigated the association between baseline spinal shape and post-fracture shape.
Twenty-seven volunteers (12 men; mean age 75.4 ± 5.4 and 15 women; mean age 71.6 ± 7.9) with VF were enrolled, and 175 volunteers (48 men, 127 women) without VF were selected as controls. In men with VF, the thoracic kyphosis apex was located significantly more posteriorly and caudally than in those without VF. In women with VF, the lordosis apex was located significantly more posteriorly and caudally than in those without VF. After fractures occurring above the inflexion vertebra, the low anterior apex spine (L5) changed its geometrical shape in that the posterior apex and the inflexion vertebra shifted significantly more posteriorly compared to the high anterior apex spine (L4/5).
Original geometrical spinal shape affected the occurrence of VF, and post-fracture spinal shape depended on the positional relationship between the inflexion vertebra and fractured vertebra. Our study helps to understand the influence of geometrical spinal shape on the risks of VF.
四年纵向队列研究。
本研究旨在探讨原始脊柱形态对偶然发生的椎体骨折（VF）的影响，并确定骨折前后几何脊柱形态变化的影响。
临床证据表明，VF 会导致老年人脊柱后凸、发病和生活质量恶化。然而，影响偶然 VF 的几何脊柱形状的知识有限。
317 名志愿者作为健康筛查的一部分，在 2012 年和 2016 年都接受了全脊柱 X 线摄影。我们从 2016 年的志愿者中提取出偶然发生 VF 的志愿者。招募了性别和年龄匹配的没有 VF 的志愿者作为对照组。比较两组的基线人口统计学变量、几何脊柱形状和脊柱骨盆参数。在偶然发生 VF 的志愿者中，我们研究了基线脊柱形状与骨折后形状之间的关系。
共纳入 27 名志愿者（12 名男性；平均年龄 75.4±5.4 岁和 15 名女性；平均年龄 71.6±7.9 岁）发生 VF，175 名志愿者（48 名男性，127 名女性）无 VF 被选为对照组。在发生在拐点椎体以上的骨折的男性中，胸椎后凸顶点明显位于更靠后和更靠下的位置。在发生 VF 的女性中，前凸顶点明显位于更靠后和更靠下的位置。在发生在拐点椎体以上的骨折之后，低前凸顶点脊柱（L5）的几何形状发生了变化，后凸顶点和拐点椎体明显向后移动，与高前凸顶点脊柱（L4/5）相比。
原始的几何脊柱形状影响 VF 的发生，骨折后的脊柱形状取决于拐点椎体和骨折椎体之间的位置关系。我们的研究有助于了解几何脊柱形状对 VF 风险的影响。
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