Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery, Chariteplatz 1, 10117, Berlin, Germany.
Medical University of Vienna, Spitalgasse 23, Vienna, 1090, Austria.
Sci Rep. 2020 Jun 1;10(1):8894. doi: 10.1038/s41598-020-65798-0.
Kyphoplasty is the standard surgical treatment of vertebral compression fractures. We aimed to clarify the influence of kyphoplasty on the sagittal profile as well as the relation between posture improvement and pain relief. For this purpose, we evaluated various radiological parameters of the sagittal profile on whole spine standing radiographs of 73 Patients with a single vertebral fracture treated by kyphoplasty. The key outcome was the postoperative change of the sagittal vertical axis (SVA). Additionally, clinical parameters including pain scores on visual analogue scale (VAS) and use of analgesics were obtained from medical records. Pre- and postoperative radiological as well as clinical parameters were compared. Additionally, the correlation between changes of SVA and changes of local kyphotic angle (LKA) or VAS was examined. The clinical parameters as well as various radiographic parameters (SVA, LKA, Gardner, Cobb) improved significantly postoperatively. The improvement of SVA correlated significantly with the correction of the LKA but not with postoperative pain relief. We conclude that kyphoplasty helps to restore the global sagittal balance of the spine after vertebral fractures. The correction of the sagittal profile seems to depend on the correction of the local kyphotic angle but does not correlate with postoperative pain relief.
椎体后凸成形术是治疗椎体压缩性骨折的标准手术方法。我们旨在阐明椎体后凸成形术对矢状面轮廓的影响，以及姿势改善与疼痛缓解之间的关系。为此，我们评估了 73 例单椎体骨折患者接受椎体后凸成形术治疗后的全脊柱站立位 X 线片的各种矢状面轮廓的影像学参数。主要结果是术后矢状垂直轴（SVA）的变化。此外，还从病历中获得了包括视觉模拟评分（VAS）疼痛评分和镇痛药使用情况在内的临床参数。比较了术前和术后的影像学和临床参数。此外，还检查了 SVA 变化与局部后凸角（LKA）或 VAS 变化之间的相关性。临床参数以及各种影像学参数（SVA、LKA、Gardner、Cobb）在术后均显著改善。SVA 的改善与 LKA 的矫正显著相关，但与术后疼痛缓解无关。我们得出结论，椎体后凸成形术有助于在椎体骨折后恢复脊柱的整体矢状平衡。矢状面轮廓的矫正似乎取决于局部后凸角的矫正，但与术后疼痛缓解无关。
