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

Video：

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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, 孫卓然, 陳忠強. 正常脊柱-骨盆矢狀位參數的影像學研究. 中華骨科雜志, 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.	汪文龍, 海涌. 椎體后凸成形術治療骨質疏松性椎體壓縮骨折的療效及傷椎影像學變化. 中國脊柱脊髓雜志, 2016, 26(11): 1054-1056.
14.	王俊魁, 劉宏建, 寇宏偉, 等. 胸腰椎骨質疏松性椎體壓縮骨折患者脊柱-骨盆矢狀位參數的研究. 中國脊柱脊髓雜志, 2016, 26(5): 408-414.
15.	劉濤, 邱水強, 徐志剛, 等. 頸椎前路椎間盤切除減壓不同融合節段對脊柱-骨盆矢狀位平衡的影響. 中國修復重建外科雜志, 2019, 33(3): 265-272.
16.	莊澄宇, 陳哲, 宋艷艷, 等. 經皮椎體成形術和經皮椎體后凸成形術治療不同壓縮程度骨質疏松性椎體骨折療效的比較. 中華創傷骨科雜志, 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, 孫卓然, 陳忠強. 正常脊柱-骨盆矢狀位參數的影像學研究. 中華骨科雜志, 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. 汪文龍, 海涌. 椎體后凸成形術治療骨質疏松性椎體壓縮骨折的療效及傷椎影像學變化. 中國脊柱脊髓雜志, 2016, 26(11): 1054-1056.
14. 王俊魁, 劉宏建, 寇宏偉, 等. 胸腰椎骨質疏松性椎體壓縮骨折患者脊柱-骨盆矢狀位參數的研究. 中國脊柱脊髓雜志, 2016, 26(5): 408-414.
15. 劉濤, 邱水強, 徐志剛, 等. 頸椎前路椎間盤切除減壓不同融合節段對脊柱-骨盆矢狀位平衡的影響. 中國修復重建外科雜志, 2019, 33(3): 265-272.
16. 莊澄宇, 陳哲, 宋艷艷, 等. 經皮椎體成形術和經皮椎體后凸成形術治療不同壓縮程度骨質疏松性椎體骨折療效的比較. 中華創傷骨科雜志, 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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