Evaluation of sagittal alignment after osteoporotic vertebral fracture

Abstract

Objective: Osteoporotic vertebral fractures (OVFs) causes local kyphosis around the fractured vertebral body. The purpose of this study was to evaluate the compensation mechanism of spinal balance for local kyphosis.

Material and Methods: We reviewed the medical records and radiographs of 75 patients who had underwent surgical treatment for non-union, kyphotic deformity and neurological disorder due to OVFs. All patients were divided into two groups; the thoracolumbar vertebral fracture group (Th10-L2) and the lower lumbar vertebral fracture group (L3-5). Spinal sagittal alignment with whole spine radiography in the standing position were measured.

Results: In thoracolumbar vertebral fracture group, the local kyphosis in the thoracolumbar level was compensated for by pelvic retrograde and lumbar lordosis. In lower lumbar vertebral fracture group, the local kyphosis in the lumbar level was compensated for by pelvic retrograde and reduction of thoracic kyphosis. OVFs at the lumbar level had higher SVA and low back pain than those at the thoracolumbar level.

Conclusion: Lumbar vertebral fractures were decompensated due to reduced lumbar lordosis.