Effect of percutaneous kyphoplasty on lumbar-pelvic correlation in osteoporotic vertebral compressive fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Tao ¹ , QIU Shuiqiang ¹ , XU Zhigang ¹ , GU Jisheng ¹ , LUO Zhendong ¹ ,  WU Desheng ²

1. Department of Orthopaedics, Jiangwan Hospital of Hongkou District of Shanghai, Shanghai, 200434, P. R. China;
2. Department of Spinal Surgery, Shanghai Oriental Hospital Affiliated to Tongji University, Shanghai, 200120, P. R. China;

Corresponding author：

WU Desheng, Email: eastspine@163.com

Keywords：

Osteoporotic vertebral compressive fracture; percutaneous kyphoplasty; lumbar-pelvic correlation

DOI：

10.7507/1002-1892.201812049

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Objective To explore the effect of percutaneous kyphoplasty (PKP) on lumbar-pelvic correlation in osteoporotic vertebral compressive fracture (OVCF).Methods According to the inclusion criteria, 63 patients with primary osteoporosis between January 2012 and June 2017 were selected as the control group and 67 patients with single-segment lumbar OVCF receiving PKP and complete clinical data were included as the observation group. There was no significant difference in gender, age, and lumbar spine bone density between the two groups (P>0.05). The visual analogue scale (VAS) score and Oswestry Disability Index (ODI) score were used to assess lumbar pain and function before operation and at 3 days after operation in the observation group; lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured in lumbar lateral X-ray films which were taken before PKP and at 1 month after PKP. The same parameters were measured in the lumbar lateral X-ray films which were taken at the time of initial diagnosis in the control group.Results All patients were followed up 3-24 months with an average of 5.8 months in the observation group. The VAS score decreased from 5.6±1.8 before PKP to 2.8±1.3 at 3 days after PKP (t=14.082, P=0.000); ODI decreased from 50.1%±5.0% before PKP to 18.2%±1.8% (t=47.011, P=0.000). Compared with the control group, the LL, PI, and SS decreased and the PT increased in the observation group, and only the difference in LL between the two groups was significant (P<0.05). In the observation group, the LL and SS significantly increased (P<0.05) and PT significantly decreased (P<0.05) at 1 month after operation when compared with preoperative ones, and PI decreased, but the difference was not significant (P>0.05). In the control group, LL was positively correlated with PI and SS (P<0.05); PI was positively correlated with PT and SS (P<0.05). In the observation group, PI was positively correlated with SS (P<0.05) before and after PKP.Conclusion OVCF patients lost the specific lumbar-pelvic correlation. PKP can restore lumbar lordosis, but it still can not restore the normal physiological fitting.

Citation： LIU Tao, QIU Shuiqiang, XU Zhigang, GU Jisheng, LUO Zhendong, WU Desheng. Effect of percutaneous kyphoplasty on lumbar-pelvic correlation in osteoporotic vertebral compressive fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(11): 1414-1418. doi: 10.7507/1002-1892.201812049 Copy

1.	李危石, 孙卓然, 陈忠强. 正常脊柱-骨盆矢状位参数的影像学研究. 中华骨科杂志, 2013, 33(5): 447-453.
2.	Mac-Thiong JM, Labelle H, Roussouly P. Pediatric sagittal alignment. Eur Spine J, 2011, 20(Suppl 5): 586-590.
3.	Jia J, Zhao Y, Liu X. Impact of sagittal imbalance correction on clinical outcomes in patients undergoing MIS-TLIF for LSS. Clin Neurol Neurosurg, 2019, 181: 119-126.
4.	Takahashi Y, Okuda S, Nagamoto Y, et al. Effect of segmental lordosis on the clinical outcomes of 2-level posterior lumbar interbody fusion for 2-level degenerative lumbar spondylolisthesis. J Neurosurg Spine, 2019, 10: 1-6.
5.	Champagne PO, Walsh C, Diabira J, et al. Sagittal balance correction following lumbar interbody fusion: a comparison of the three approaches. Asian Spine J, 2019, 13(3): 450-458.
6.	Du CZ, Li S, Xu L, et al. Sagittal reconstruction of lumbosacral contiguous double-level spondylolytic spondylolisthesis: a comparison of double-level and single-level transforaminal lumbar interbody fusion. J Orthop Surg Res, 2019, 14(1): 148.
7.	Barrey C, Jund J, Noseda O, et al. Sagittal balance of the pelvis-spine complex and lumber degenerative disease. A comparative study about 85 cases. Eur Spine J, 2007, 16(9): 1459-1467.
8.	Wei X, Gengwu L, Chao C, et al. Correlations between the sagittal plane parameters of the spine and pelvis and lumbar disc degeneration. J Orthop Surg Res, 2018, 13(1): 137.
9.	Tamai K, Grisdela P, Romanu J, et al. The impact of cervical spinal muscle degeneration on cervical sagittal balance and spinal degenerative disorders. Clin Spine Surg, 2019, 32(4): E206-E213.
10.	Innmann MM, Merle C, Gotterbarm T, et al. Can spinopelvic mobility be predicted in patients awaiting total hip arthroplasty? A prospective, diagnostic study of patients with end-stage hip osteoarthritis Bone Joint J, 2019, 101-B(8): 902-909.
11.	Zhu Z, Xu L, Zhu F, et al. Sagittal alignment of spine and pelvis in asymptomatic in adults: norms in Chinese populations. Spine (Phila Pa 1976), 2014, 39(1): E1-E6.
12.	Saxena BP, Shah BV, Joshi SP. Outcome of percutaIleous balloon kypholasty in vertebral compression fractures. Indian J Orthop, 2015, 49(4): 458-464.
13.	汪文龙, 海涌. 椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效及伤椎影像学变化. 中国脊柱脊髓杂志, 2016, 26(11): 1054-1056.
14.	王俊魁, 刘宏建, 寇宏伟, 等. 胸腰椎骨质疏松性椎体压缩骨折患者脊柱-骨盆矢状位参数的研究. 中国脊柱脊髓杂志, 2016, 26(5): 408-414.
15.	刘涛, 邱水强, 徐志刚, 等. 颈椎前路椎间盘切除减压不同融合节段对脊柱-骨盆矢状位平衡的影响. 中国修复重建外科杂志, 2019, 33(3): 265-272.
16.	庄澄宇, 陈哲, 宋艳艳, 等. 经皮椎体成形术和经皮椎体后凸成形术治疗不同压缩程度骨质疏松性椎体骨折疗效的比较. 中华创伤骨科杂志, 2013, 15(9): 773-777.
17.	Qi Y, Zeng Y, Jiang C, et al. Comparison of percutaneous kyphoplasty versus modified percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures. World Neurosurg, 2019, 122: e1020-e1027.
18.	Rolliinghoff M, Siewe J, Zarghooni K, et al. Effctiveness, security and height resoration on fresh comprssion fractures-a comparative prospective study of vertebroplasty and kyphoplasty. Minim Invasive Neurosurg, 2009, 52(5-6): 233-237.

1. 李危石, 孙卓然, 陈忠强. 正常脊柱-骨盆矢状位参数的影像学研究. 中华骨科杂志, 2013, 33(5): 447-453.
2. Mac-Thiong JM, Labelle H, Roussouly P. Pediatric sagittal alignment. Eur Spine J, 2011, 20(Suppl 5): 586-590.
3. Jia J, Zhao Y, Liu X. Impact of sagittal imbalance correction on clinical outcomes in patients undergoing MIS-TLIF for LSS. Clin Neurol Neurosurg, 2019, 181: 119-126.
4. Takahashi Y, Okuda S, Nagamoto Y, et al. Effect of segmental lordosis on the clinical outcomes of 2-level posterior lumbar interbody fusion for 2-level degenerative lumbar spondylolisthesis. J Neurosurg Spine, 2019, 10: 1-6.
5. Champagne PO, Walsh C, Diabira J, et al. Sagittal balance correction following lumbar interbody fusion: a comparison of the three approaches. Asian Spine J, 2019, 13(3): 450-458.
6. Du CZ, Li S, Xu L, et al. Sagittal reconstruction of lumbosacral contiguous double-level spondylolytic spondylolisthesis: a comparison of double-level and single-level transforaminal lumbar interbody fusion. J Orthop Surg Res, 2019, 14(1): 148.
7. Barrey C, Jund J, Noseda O, et al. Sagittal balance of the pelvis-spine complex and lumber degenerative disease. A comparative study about 85 cases. Eur Spine J, 2007, 16(9): 1459-1467.
8. Wei X, Gengwu L, Chao C, et al. Correlations between the sagittal plane parameters of the spine and pelvis and lumbar disc degeneration. J Orthop Surg Res, 2018, 13(1): 137.
9. Tamai K, Grisdela P, Romanu J, et al. The impact of cervical spinal muscle degeneration on cervical sagittal balance and spinal degenerative disorders. Clin Spine Surg, 2019, 32(4): E206-E213.
10. Innmann MM, Merle C, Gotterbarm T, et al. Can spinopelvic mobility be predicted in patients awaiting total hip arthroplasty? A prospective, diagnostic study of patients with end-stage hip osteoarthritis Bone Joint J, 2019, 101-B(8): 902-909.
11. Zhu Z, Xu L, Zhu F, et al. Sagittal alignment of spine and pelvis in asymptomatic in adults: norms in Chinese populations. Spine (Phila Pa 1976), 2014, 39(1): E1-E6.
12. Saxena BP, Shah BV, Joshi SP. Outcome of percutaIleous balloon kypholasty in vertebral compression fractures. Indian J Orthop, 2015, 49(4): 458-464.
13. 汪文龙, 海涌. 椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效及伤椎影像学变化. 中国脊柱脊髓杂志, 2016, 26(11): 1054-1056.
14. 王俊魁, 刘宏建, 寇宏伟, 等. 胸腰椎骨质疏松性椎体压缩骨折患者脊柱-骨盆矢状位参数的研究. 中国脊柱脊髓杂志, 2016, 26(5): 408-414.
15. 刘涛, 邱水强, 徐志刚, 等. 颈椎前路椎间盘切除减压不同融合节段对脊柱-骨盆矢状位平衡的影响. 中国修复重建外科杂志, 2019, 33(3): 265-272.
16. 庄澄宇, 陈哲, 宋艳艳, 等. 经皮椎体成形术和经皮椎体后凸成形术治疗不同压缩程度骨质疏松性椎体骨折疗效的比较. 中华创伤骨科杂志, 2013, 15(9): 773-777.
17. Qi Y, Zeng Y, Jiang C, et al. Comparison of percutaneous kyphoplasty versus modified percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures. World Neurosurg, 2019, 122: e1020-e1027.
18. Rolliinghoff M, Siewe J, Zarghooni K, et al. Effctiveness, security and height resoration on fresh comprssion fractures-a comparative prospective study of vertebroplasty and kyphoplasty. Minim Invasive Neurosurg, 2009, 52(5-6): 233-237.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of percutaneous kyphoplasty on lumbar-pelvic correlation in osteoporotic vertebral compressive fractures

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