ABSTRACT
Objective To explore the correlation between spinal sagittal balance and quality of life after the treatment of percutaneous kyphoplasty in osteoporotic vertebral compressive fractures. Methods We retrospec-tively enrolled and screened 85 patients with osteoporotic vertebral compression fractures(OVCF),treated by per-cutaneous kyphoplasty(PKP)in spinal surgery department of Shanghai East Hospital from January 2012 to Decem-ber 2016. The full length of the spine X-ray examinations had been taken preoperatively,pre-discharge and during the follow-up and spine-pelvis sagittal parameters included C7 sagittal vertical axis(C7SVA),thoracic kyphosis (TK),lumber lordosis(LL),pelvic incidence(PT)and sacral slope(SS). Shot Form 36 Health Survey Question-naire(SF-36)was used for the scoring. Results In the last follow-up,C7SVA decreased from(35.9 ± 17.1)mm to(30.8 ± 12.8)mm(P=0.002)and SF-36 scores varied significantly(P<0.01). Before the surgery,follow-up 3 days,6 months and 12 months after the surgery,C7SVA was negatively correlated with the general health status in each period of SF-36(r=-0.343,-0.264,-0.272,-0.258;P=0.001,0.015,0.012,0.017). Conclusions PKP has a significant effect on OVCFs and changes the spine-pelvic sagittal balance in patients with OVCF. Spinal-pel-vic sagittal balance is closely related to the quality of life of these patients.
ABSTRACT
Objective To explore the relationships between the alterations of cervical sagittal parameters and clinical outcomes after anterior cervical discectomy and fusion (ACDF).Methods From January 2010 to December 2015,a total of 227 patients with cervical spondylosis who undelwent ACDF in Dongfang Hospital affiliated Tongji University were analyzed in this study.There were 109 male and 118 female,with an average age of 52.2± 10.7 years (ranged from 34 to 78 years).The average duration of follow-up after revision surgery was (21.1 ±9.0) months (12-60 months).Comparing with Japanese 0rthopaedic Association (JOA) score and its improvement rate (IR),visual analogue scale (VAS) scores and neck disability index (NDI) between preoperation and 1 year follow-up.Cervical alignment was assessed with the following 3 parameters:T1 slope (T1S),Cobb's angle of C2 to C7 and C2-7 sagittal vertical axis (SVA).And compared the changes of sagittal parameters and clinical efficacy.Results At 1 year follow-up,T1S was increased from 25.4°±8.5° to 27.9°±8.2°,Cobb's angle was increased from 12.7°±8.5° to 15.3°±9.5°,SVA was increased from (21.0± 12.3) mm to (24.30± 11.4) mm,and the differences were statistical significant (P＜ 0.001).JOA score was increased from (8.5±4.0) points to (13.0±2.4) points at 1 year follow-up,however,VAS score was decreased from 2.7± 1.8 points to 0.2±0.4 points,and NDI was decreased from 48.2％±8.2％ to 27.1％± 11.1％,and the differences were statistical significant (P ＜ 0.001).Preoperatively,T1S had positive correlations with both Cobb's angle and SVA before operation (r=0.311,0.213;P=0.000,0.001),but Cobb's angle had negative correlation with SVA (r=-0.246,P=0.000).At 1 year follow-up,T1S had positive correlations with Cobb's angle and SVA (r=0.390,0.392;P=0.000,0.000),and Cobb's angle had negative correlation with SVA (r=-0.131,P=0.048).At 1 year after operation,the change value of Cobb's angle had positive correlation with the change of JOA (r=0.294,P=0.000),but negative correlation with the change of NDI (r=-0.141,P=0.034).Conclusion ACDF is effective in the treatment of cervical spondylosis which the cervical sagittal alignment remains relatively stable,and there were significant correlation between the alteration of cervical sagittal parameters and clinical outcomes after ACDF.