Vertebral fractures and spinopelvic parameters in patients with osteoporosis

Abstract

Aim: Bone mineral density (BMD) generally assesses fracture risk in the elderly but is not included in assessment of vertebral fracture status. In this study we aimed to investigate spinal alignment and pelvic orientation in patients with osteoporosis and identify indicators of vertebral fractures (VFs).

Methods: Seventy patients above 50 years of age with osteoporosis were included in this retrospective cohort study. Patients were allocated to two groups comprising 29 patients with and 41 patients without VFs. Demographic and clinical characteristics and back pain scores evaluated by Visual Analogue Scale were obtained by scanning patient files. Sagittal vertebral axis (SVA), spinal and pelvic parameters were evaluated with lateral radiography. All parameters and their effect of VFs were compared in both groups. 

Results: Femoral neck BMD, sacral slope, lumbar lordosis, and pain scores were significantly different in patients with and without VFs (P=0.016, P=0.032, P=0.010, P<0.001, respectively). However, no significant difference was observed in terms of lumbar spine BMD, pelvic tilt, pelvic incidence, and thoracic kyphosis (P=0.394, P=0.313, P=0.258, P=0.341, respectively). Sacral slope and lumbar lordosis were positively correlated in patients with and without VFs (r=0.54, P=0.003 and r=0.50, P=0.001, respectively). SVA>50 mm and pain scores were predictors of VFs according to results of logistic regression. 

Conclusion: The spinal deformity in patients with osteoporosis may be explained by the spinal parameters. In our study, we concluded that pain and sagittal imbalance in osteoporosis patients are important parameters for vertebral fractures.

Keywords

• Osteoporosis,Sagittal balance,Spinopelvic parameters,Vertebral fracture

Osteoporozlu hastalarda vertebral kırıklar ve spinopelvik parametreler

Öz

Amaç: Kemik mineral yoğunluğu (KMY) genellikle yaşlı bireylerin kırık riski değerlendirmesini gösterir ancak vertebral kırık durumunun değerlendirilmesini içermez. Biz bu çalışmada osteoporozlu hastalarda spinal sagital denge bozukluğu ve pelvik uyum bozukluklarını araştırmayı ve vertebral kırıkların (VK) tahmini göstergelerini tanımlamayı amaçladık.

Yöntemler: Bu retrospektif kohort çalışmada 50 yaş üzeri 70 osteoporoz hastası dahil edildi. Hastalar vertebral kırıkları olan; 29 VK(+) ve olmayan; 41 VK(-) olmak üzere iki gruba ayrıldı. Demografik ve klinik özellikler ile Görsel Analog Skala ile ölçülen sırt ağrısı skorları dosya taraması yolu ile elde edildi. Lateral radyolojik inceleme ile sagital vertebral aks (SVA), spinal ve pelvik parametreler değerlendirildi. Tüm parametreler her iki grupta da karşılaştırıldı ve bu parametrelerin VK üzerindeki etkisi analiz edildi.

Bulgular: Vertebral kırığı olan ve olmayan hastalarda femur boynu KMY, sakral eğim, lomber lordoz ve ağrı skorlarının anlamlı derecede farklı olduğu bulundu (sırasıyla P=0.016, P=0.032, P=0.010, P<0.001). Bununla birlikte, lomber omurga KMY, pelvik

tilt, pelvik insidans ve torakal kifoz açısından anlamlı bir fark gözlenmedi (sırasıyla P=0.394, P=0.313, P=0.258, P=0.341). Sakral eğim ile lomber lordoz arasında pozitif anlamlı bir korelasyon bulunmuştur (sırasıyla r=0.54, P=0.03 ve r=0.50, P=0.001). Lojistik regresyon sonuçlarına göre SVA >50 mm ve ağrı skorları VK’ın belirleyicileriydi.

Sonuç: Osteoporozlu hastalarda omurga deformitesi omurga parametreleriyle açıklanabilir. Çalışmamızda osteoporoz hastalarında ağrı ve sagital dengesizliğin, vertebral kırıkların göstergeleri olduğu sonucuna varıldı.

Anahtar Kelimeler

• Osteoporoz,Sagital denge,Spinopelvik parametreler,Vertebral kırık

Kaynakça

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