Beyersdorf Christoph, Prost Max, Röckner Melanie Elisabeth, Maus Uwe Martin, Jacobs Cornelius, Scheyerer Max Joseph
Department of Orthopaedic and Trauma Surgery, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
Department of Orthopaedic and Trauma Surgery, St. Remigius Hospital Leverkusen, Leverkusen, Germany.
J Orthop Surg Res. 2025 Jan 9;20(1):23. doi: 10.1186/s13018-025-05454-3.
Osteoporosis, a skeletal disorder affecting nearly 20% of the global population, poses a significant health concern, with osteoporotic vertebral body fractures (VBF) representing a common clinical manifestation. The impact of osteoporotic sintering fractures in the thoracolumbar spine on the sagittal lumbar profile is incompletely understood and may lead to the onset of clinical symptoms in previously asymptomatic patients.
This retrospective single-center study analyzed data from patients presenting with osteoporotic spine fractures between 2017 and 2022. Patient selection involved stringent inclusion and exclusion criteria, focusing on radiologically documented osteoporotic sintering fractures in the thoracolumbar junction (TH11-L2). Clinical parameters were recorded and analyzed, alongside lateral-view radiographic assessments utilizing the IDS 7-PACS-System (Sectra, Linköping, Sweden). Measurements included total lumbar lordosis, lordosis caudal to the fracture, kyphosis of the fractured vertebra, and sacral slope. Statistical analysis was conducted using SPSS 27 (IBM, Armonk, USA).
Thirty patients (73.3% female, 26.7% male) met the inclusion criteria, with an average age of 82.4 years. Analysis revealed a significant increase in kyphosis of the fractured vertebra in the thoracolumbar spine (p < 0.0001) following further sintering of osteoporotic VBF with increased lordosis caudal to the fracture (p < 0.0001). Total lumbar lordosis remained unchanged, alongside sacral slope measurements (p = 0.612 and p = 0.863, respectively).
Progressive sintering of osteoporotic fractures in the thoracolumbar junction accentuates lordosis in underlying segments, potentially exacerbating degenerative changes and symptomatic manifestations. Thus, prioritizing interventions aimed at preventing progressive sintering and restoring sagittal balance is paramount in optimizing treatment outcomes for affected individuals.
骨质疏松症是一种影响全球近20%人口的骨骼疾病，是一个重大的健康问题，骨质疏松性椎体骨折（VBF）是其常见的临床表现。胸腰椎骨质疏松性椎体骨折对腰椎矢状面轮廓的影响尚未完全明确，可能导致既往无症状患者出现临床症状。
这项回顾性单中心研究分析了2017年至2022年期间出现骨质疏松性脊柱骨折患者的数据。患者选择涉及严格的纳入和排除标准，重点是胸腰段（T11-L2）经放射学记录的骨质疏松性椎体骨折。记录并分析临床参数，同时使用IDS 7-PACS系统（Sectra，瑞典林雪平）进行侧位X线评估。测量指标包括腰椎前凸总和、骨折下方的前凸、骨折椎体的后凸以及骶骨倾斜度。使用SPSS 27（IBM，美国阿蒙克）进行统计分析。
30例患者（73.3%为女性，26.7%为男性）符合纳入标准，平均年龄82.4岁。分析显示，骨质疏松性VBF进一步椎体压缩后，胸腰椎骨折椎体的后凸显著增加（p < 0.0001），骨折下方的前凸增加（p < 0.0001）。腰椎前凸总和以及骶骨倾斜度测量值保持不变（分别为p = 0.612和p = 0.863）。
胸腰段骨质疏松性骨折的进行性椎体压缩会加重下方节段的前凸，可能加剧退变改变和症状表现。因此，在优化对受影响个体的治疗效果方面，优先采取旨在预防进行性椎体压缩和恢复矢状面平衡的干预措施至关重要。
