Effects of fresh lumbar osteoporotic vertebral compression fracture on spinopelvic sagittal parameters and distribution of Roussouly types / 中华创伤骨科杂志

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.