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European Spine Journal

Erschienen in:

26.07.2023 | Original Article

Predictive factors for conversion from conservatively to surgically treatment osteoporotic thoracolumbar compression fractures based on sagittal parameters and magnetic resonance imaging features

verfasst von: Hoon-Seok Sung, Sang-Il Kim, Hyung-Youl Park, Myung-Sup Ko, Jeong-Han Lee, Young-Hoon Kim

Erschienen in: European Spine Journal | Ausgabe 11/2023

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Abstract

Purpose

To investigate the relationship between sagittal plane characteristics of the spinal column and conservative treatment failure in acute osteoporotic spinal fractures (OSFs).

Methods

As a retrospective study of single-institute data, thoracolumbar OSF patients with similar propensities in terms of location of fractures and results of bone mineral density were analyzed. Among them, 43 patients (group I) who needed reconstructive surgical interventions and 39 patients (group II) who obtained successful treatment through conservative care were included. General demographic data, radiographic features of fractures, and magnetic resonance imaging (MRI) features of fractures were analyzed. To investigate the relationship between global sagittal alignment of the spine and occurrence of delayed complication following OSFs, radiological sagittal parameters were analyzed.

Results

The number of cases requiring reconstructive surgery was significantly higher when the index vertebra showed diffuse or mid-portion bone marrow changes in MRI. In terms of sagittal parameters, pelvic incidence (group I 59.1° ± 11.9°, group II 54.6° ± 9.8°) and thoracolumbar angle (group I 26.5° ± 14.1°, group II 17.4° ± 11.2°) were significantly higher in group I. Logistic regression analysis showed that higher pelvic incidence (OR 1.09, 95% CI 1.01–1.18, p value < 0.05) and higher thoracolumbar angle (OR 1.09, 95% CI 1.02–1.17, p value < 0.05) were significant risk factors for delayed complications requiring reconstructive surgery following OSFs.

Conclusion

Delayed complications requiring reconstructive surgery following OSFs are related to sagittal plane parameters of the spine such as high pelvic incidences, in addition to previously known radiographic characteristics of fractures.

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Titel: Predictive factors for conversion from conservatively to surgically treatment osteoporotic thoracolumbar compression fractures based on sagittal parameters and magnetic resonance imaging features
verfasst von: Hoon-Seok Sung
Sang-Il Kim
Hyung-Youl Park
Myung-Sup Ko
Jeong-Han Lee
Young-Hoon Kim
Publikationsdatum: 26.07.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 11/2023
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-023-07864-5

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Predictive factors for conversion from conservatively to surgically treatment osteoporotic thoracolumbar compression fractures based on sagittal parameters and magnetic resonance imaging features

Abstract

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Results

Conclusion

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