Bae In-Suk, Moon Byung Gwan, Kang Hee In, Kim Jae Hoon, Jwa Cheolsu, Kim Deok Ryeong
Department of Neurosurgery, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
Department of Neurosurgery, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea.
Neurospine. 2022 Jun;19(2):357-366. doi: 10.14245/ns.2143172.586. Epub 2022 May 17.
We retrospectively analyzed patients with osteoporotic vertebral compression fracture (OVCF) undergoing vertebral augmentation to compare the Cobb angle changes in the supine and standing positions and the clinical outcomes.
We retrospectively extracted the data of OVCF patients who underwent vertebral augmentation. Back pain was assessed using a visual analogue scale (VAS). Supine and standing radiographs were assessed before treatment to determine the Cobb angle and compression ratio. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff to predict favorable outcomes after vertebral augmentation.
A total of 249 patients were included. We observed a statistically significant increase in the VAS score change with increasing Cobb angle and compression ratio (p < 0.001), and multivariate logistic regression analysis showed that a difference in the Cobb angle (odds ratio [OR], 1.27) and compression ratio (OR, 1.12) were the independent risk factors for predicting short-term favorable outcomes after vertebral augmentation. In addition, we found that the difference in the Cobb angle (OR, 1.05) was the only factor for predicting midterm favorable outcomes after vertebral augmentation. The optimal cutoff value of the difference in the Cobb angle for predicting midterm favorable outcomes was 35.526°.
We found that the midterm clinical outcome after vertebral augmentation was better when there was a difference of approximately 35% or more in the Cobb angle between the standing and supine positions. Surgeons should pay attention to the difference in the Cobb angle depending on the posture when deciding to perform vertebral augmentation in patients with OVCFs.
我们回顾性分析了接受椎体强化治疗的骨质疏松性椎体压缩骨折（OVCF）患者，以比较仰卧位和站立位时的Cobb角变化及临床疗效。
我们回顾性提取了接受椎体强化治疗的OVCF患者的数据。使用视觉模拟评分法（VAS）评估背痛情况。在治疗前评估仰卧位和站立位的X线片，以确定Cobb角和压缩率。进行受试者操作特征曲线分析，以确定预测椎体强化治疗后良好结局的最佳截断值。
共纳入249例患者。我们观察到随着Cobb角和压缩率的增加，VAS评分变化有统计学意义的增加（p<0.001），多因素逻辑回归分析显示，Cobb角差异（优势比[OR]，1.27）和压缩率差异（OR，1.12）是预测椎体强化治疗后短期良好结局的独立危险因素。此外，我们发现Cobb角差异（OR，1.05）是预测椎体强化治疗后中期良好结局的唯一因素。预测中期良好结局的Cobb角差异的最佳截断值为35.526°。
我们发现，当站立位和仰卧位的Cobb角差异约为35%或更大时，椎体强化治疗后的中期临床疗效更好。对于决定对OVCF患者进行椎体强化治疗的外科医生，应注意根据姿势不同而产生的Cobb角差异。
