The Effects of Sagittal Spino-Pelvic Alignment on the Clinical Symptoms of Thoracolumbar Kyphosis in Osteoporotic Patients
10.4184/jkss.2019.26.3.76
- Author:
Whoan Jeang KIM
1
;
Dae Geon SONG
;
Jae Won LEE
;
Shann Haw CHANG
;
Kun Young PARK
;
Yong Ho KIM
;
Sang Beom MA
;
Won Sik CHOY
Author Information
1. Department of Orthopedic Surgery, College of Medicine, Eulji University, Daejeon, Korea. jaystar4u@naver.com
- Publication Type:Original Article
- From:Journal of Korean Society of Spine Surgery
2019;26(3):76-83
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES:The purpose of this study was to assess the effect of sagittal spino-pelvic alignment on the clinical symptoms of thoracolumbar kyphosis (TLK; T10-L2 Cobb's angle >20°) in osteoporotic patients.SUMMARY OF LITERATURE REVIEW: Few studies have investigated the clinical symptoms and radiological features of TLK caused by degenerative changes. There is also controversy over whether clinical symptoms will deteriorate in patients with TLK or which treatment should be chosen according to the degree of TLK.
MATERIALS AND METHODS:From May 2005 to May 2016, we reviewed 75 patients who were diagnosed with TLK (T10-L2 Cobb's angle >20°) and osteoporosis. Patients were excluded from the study if they had neurological symptoms, underlying spinal disorders, or unstable vertebral fractures. Fifty patients with TLK due to an osteoporotic vertebral compression fracture (group F) and 25 patients with senile TLK (group S) were assessed by clinical symptoms and radiological parameters. Thoracolumbar kyphosis angle and sagittal vertical axis (SVA) were also analyzed. Clinical symptoms were assessed using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI).
RESULTS:There were no significant differences in clinical symptoms (VAS, ODI) and radiological parameters between groups F and S, or according to the degree of TLK(20°–30°, 30°–40°, >40°). Clinical symptoms were significantly more severe in patients with sagittal imbalance (SVA >5 cm) than in those with sagittal balance.
CONCLUSIONS:Sagittal imbalance is a more important factor affecting clinical symptoms than the cause or the degree of TLK. Therefore, sagittal imbalance should be considered in the management of TLK in osteoporotic patients.
