ABSTRACT
Objective To investigate the effects of fresh lumbar osteoporotic vertebral compression fracture (OVCF) on spinopelvic sagittal parameters and distribution of Roussouly types.Methods One hundred and eight patients with one-level fresh lumbar OVCF and 110 patients with simple osteoporosis (OP) were diagnosed and treated at Department of Orthopedic Surgery,Shougang Hospital from January 2016 to August 2017.The basic clinical data of all the patients were documented and their lumber spines were classified by Roussouly types.The 2 groups were compared in terms of spinopelvic sagittal parameters such as pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),and lumbar lordosis (LL) and Roussouly types.The correlation between Roussouly types and fracture segments was observed in OVCF group.Results There was no significant different in PI between OVCF and OP groups (50.35° ± 11.00° versus 51.96° ± 11.73°) (P ＞ 0.05).PT in OVCF group (18.79°± 9.51°) was significantly larger than that (16.19°± 9.03°) in OP group while SS (31.56° ± 7.88°) and LL (40.22°± 12.29°) in the former significantly smaller than those in the latter (35.77° ± 8.82° and 47.89° ± 13.20°,respectively) (P ＜ 0.05).Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OVCF group were 35,40,28 and 5 cases,respectively,with types Ⅰ and Ⅱ accounting for 69.5％;Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OP group were 17,30,49 and 14 cases,respectively,with type Ⅲ being predominant (44.5％).There was a significant difference between the 2 groups in distribution of Roussouly types (P ＜03.05).In OVCF group,fractures of L1 and L2 vertebrae accounted for 82.4％.There was a significant correlation between fracture segments and lumbar Roussouly types (P =0.034).Conclusions Patients with fresh lumbar OVCF tend to have a forward gravity and sagittal disequilibrium,leading to posterior pelvic rotation,increased PT,decreased SS,and downward shift of the apex of the lumbar curve.Their Roussouly classification is mainly type Ⅰ or type Ⅱ.
ABSTRACT
Objective To investigate the differences in some measured paremeters on spino-pelvic sagittal X-ray films in middle-aged and elderly patients between lumbar spondylolysis and isthmic spondylolisthesis,and to explore the predictors that the spondylolysis at lumbar 5 may develope into spondylolisthesis in order to provide imaging details for the clinical treatment of teenage patients with lumbar spondylolysis.Methods Imaging data of 60 patients with spondylolysis at lumbar 5 and other 60 with isthmic spondylolisthesis in middle or elder age in our hospital were analyzed retrospectively,and a control group with 60 normal volunteers were recruited in this study.Some parameters including the angles of pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),lumbar-sacral angle (LSA)and lumbar lordosis (LL),and the sagittal vertical axis (SVA)were measured in sagittal radiographs of the spine and pelvis. Differences in sagittal parameters among 3 groups were analyzed by one-way variance analysis and SNK-q test.Results The PI,PT, SS and LL were higher,and LSA was lower in patients with isthmic spondylolisthesis than those in the control group and lumbar spondylolysis one (P0.05).No significant differences in all spino-pelvic sagittal parameters were found between lumbar spondylolysis group and the control (P>0.05).Conclusion Such spino-pelvic sagit-tal parameters as PI,PT,SS,LL and LSA on X-ray film can be regarded as predictors that lumbar 5 spondylolysis may develop into spondylolisthesis and may provide imaging reference for the clinical treatment of teen-age patients with lumbar spondylolysis.