Background: Previous studies have reported the impact of thoracolumbar kyphosis induced by spinal burst fracture on spinopelvic sagittal alignment. But no study has analyzed the effects of short segment fixation on perioperative spinopelvic parameters in patients with spinal burst fracture. Thus, this study aimed to explore the impact of short segment fixation on spinopelvic sagittal alignment in patients with thoracolumbar fractures.Methods: Perioperative radiographs of 42 patients with thoracolumbar fractures treated with short-segment fixation surgery were obtained. The pelvic and spinal parameters were measured, and the influence of fracture site on all parameters was retrospectively analyzed. A descriptive analysis characterizing these parameters and multivariate analysis was performed to investigate the influencing factors of thoracolumbar kyphosis.Results: The mean age of included cases was 47.1±9.9 years, Pelvic incidence(PI) was 44.1±4.7º. Preoperative fractured level kyphosis (FLK) and thoracolumbar kyphosis(TLK) were 10.3±9.9º and 15.6±10.4º, respectively. Operative corrected degree(OCD) of FLK and TLK were 6.8±7.9º and 7.7±8.4º, respectively. Preoperative parameters, including FLK, TLK, Pelvic tilt (PT), Sacral slope (SS), Lumbar lordosis (LL), were no different in the different fracture sites. PT-OCD is greater in L2~L5 fractures than T12~L1(t=0.82, P=0.03). FLK-OCD(B=0.36), LL-OCD(B=-0.34) and PT-OCD(B=0.22), as well as age(B=-0.23) were independent factors to influence TLK-OCD. pelvis anteversion and high FLK-OCD was associated with a more satisfactory correction of the TLK deformity. TLK-OCD was negatively influenced by age. Conclusion: Short segment fixation surgery can correct TLK caused by fractures. Satisfactory TLK-OCD is related to excellent fracture reduction, pelvis anteversion, and younger patients. With FLK fixed by operation, the pelvis rotates from rear to front, more obviously in lumbar fractures.
To evaluate the effects of Chêneau bracing on Cobb’s angle (CA) and spinopelvic parameters in adolescent idiopathic scoliosis (AIS) patients. In this retrospective study, we evaluated 51 AIS patients who received Chêneau bracing treatment between January 2020 and August 2021. The prebracing and in-bracing radiographs were analyzed about the spinopelvic parameters. The CA, pelvic coronal obliquity angle, thoracolumbar kyphosis (TLK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical angle, and coronal vertical angle were measured. Paired t-test was used to compare prebracing and in-bracing spinopelvic parameters. The Pearson correlation analysis was used to identify the relationships between the variations in the spinopelvic parameters. The mean age at the initiation of bracing was 13.6 ± 1.5 years. The mean prebracing CA was 24.0° ± 6.3°. There were no statistically significant differences between prebracing and in-bracing measurements of sagittal and coronal vertical angles. However, there were statistically significant differences between the prebracing and in-bracing measurements of the CA, pelvic coronal obliquity angle, TLK, LL, PT, and SS. A significant correlation was observed between PT and thoracolumbar kyphosis variations in the sagittal plane. The pelvic coronal obliquity angle variation was correlated to the prebracing pelvic coronal obliquity angle in the coronal plane. Chêneau’s bracing effects of AIS can be extended to the pelvis. Affected by the Chêneau brace, the pelvis should be retro-rotated correspondingly to TLK hyperkyphosis on the sagittal plane, whereas in the coronal plane, pelvic obliquity was improved independently. The effect of Chêneau braces on the pelvic parameters should be fully considered before bracing treatment.
Background: Thoracolumbar kyphosis induced by spinal fractures can alter the overall sagittal alignment. There is a lack of literature analyzing the effects of short segment fixation on spinopelvic parameters in patients with spinal burst fracture. This study aimed to explore the impact of short segment fixation on spinopelvic sagittal alignment in patients with thoracolumbar fractures.Methods: We performed a retrospective analysis of thoracolumbar fracture cases treated with short-segment fixation surgery at our institution from February 2018 to July 2022. Perioperative radiographs of 42 patients were obtained. The pelvic and spinal parameters were measured, and the influence of fracture site on all parameters was retrospectively analyzed. A descriptive analysis characterizing these parameters and multivariate analysis was performed to investigate the influencing factors of thoracolumbar kyphosis.Results: The mean age of included cases was 47.1±9.9 years, Pelvic incidence was 44.1±4.7º. Preoperative fractured level kyphosis (FLK) and thoracolumbar kyphosis(TLK) were 10.3±9.9º and 15.6±10.4º, respectively. Operative corrected degree(OCD) of FLK and TLK were 6.8±7.9º and 7.7±8.4º, respectively. Preoperative parameters, including FLK, TLK, Pelvic tilt (PT), Sacral slope (SS), Lumbar lordosis (LL), were no different in the different fracture sites. PT-OCD is greater in L2~L5 fractures than in T12~L1(t=0.82, P=0.03). FLK-OCD(B=0.36), LL-OCD(B=-0.34) and PT-OCD(B=0.22), as well as age(B=-0.23) were independent factors to influence TLK-OCD. pelvis anteversion and high FLK-OCD was associated with a more satisfactory correction of the TLK deformity. TLK-OCD was negatively influenced by age. Conclusions: Short segment fixation surgery can correct TLK caused by fractures. Satisfactory TLK-OCD is related to excellent fracture reduction, pelvic anteversion, and younger patients. With FLK fixed by operation, the pelvis rotates from rear to front, more obviously in lumbar fractures.
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