Relationship between Global Sagittal Alignment and Severity of Vertebral Fracture in Patients with Osteoporosis
Refereed conference paper presented and published in conference proceedings


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AbstractSummary
This study compared the global sagittal alignment between osteoporotic patients with and without vertebral fracture (VF). The patients with VF had a worse overall global sagittal alignment. There was a negative effect of the number and severity of VF on global alignment. The osteoporotic patients with a poorer sagittal global alignment may imply more severe VF.
Hypothesis
The patients with VF had a worse sagittal alignment when compared with those without VF. The number and severity of VFs are determinants of the global sagittal balance in patients with osteoporosis.
Design
Prospective, observational study
Introduction
Osteoporotic vertebral fracture of the spine is very common and associated with the increased mortality, morbidity and overall decline in quality of life in the elderly. Studies showed that osteoporotic patients with VF had significantly higher thoracic kyphosis and lower lumbar lordosis. However, the influence of VF on whole-body compensatory mechanism, including pelvic retroversion and knee flexion, remains unclear. The aim of this study was to investigate the relationship between the global sagittal alignment and severity of VF in patients with osteoporosis.
Methods
A cohort of 72 osteoporotic subjects with or withour VF were prospectively enrolled. Clinical assessment, including age, BMD and bone mineral density were recorded. Global sagittal alignment was taken with biplanar low-dose imaging system. The number and location of VF were assessed, and the severity of VF was evaluated by Spinal Deformity Index. Measurement on global sagittal alignment was done by using T1 pelvic angle (TPA) and global sagittal angle (GSA) (Fig 1). Quality of life was assessed by Oswestry Disability Index (ODI) and Short-form (SF)-12.
Results
The TPA and GSA were significantly correlated with SF-12 and ODI. The patients with VF had significantly higher TPA and GSA (Table 1). The number and severity of VF significantly correlated with global sagittal alignment. Discriminative value for identification of patients with at least one VF, assessed by Area Under the Curves were 0.652
and 0.706 for TPA and GSA, respectively. Multivariate analysis showed parameters significantly associated with abnormal global alignment were the number and severity of VF.
Conclusion
The osteoporotic patients with VF had a worse overall global sagittal alignment. The number and severity of VF are strong determinants of global sagittal balance. The patients with a poorer sagittal global alignment may imply more severe vertebral fracture.
All Author(s) ListZongshan Hu, Gene C.W. Man, Sheung Wai Law, Anthony Kwok, Jack C.Y. Cheng
Name of Conference25th International Meeting on Advanced Spine Techniques (IMAST)
Start Date of Conference11/07/2018
End Date of Conference14/07/2018
Place of ConferenceLos Angeles, CA
Country/Region of ConferenceUnited States of America
Proceedings TitleThe Proceeding of 25th International Meeting on Advanced Spine Techniques (IMAST)
Year2018
Month7
Pages84 - 85
LanguagesEnglish-United Kingdom

Last updated on 2018-06-12 at 10:12