Prediction of sagittal balance in patients with osteoporosis using spinopelvic parameters

Lee, Jung Sub; Lee, Hong Seok; Shin, Jong Ki; Goh, Tae Sik; Son, Seung Min

doi:10.1007/s00586-013-2672-1

Cited by 33 publications

(23 citation statements)

References 29 publications

(34 reference statements)

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“…Since women's SVA was significantly larger than men's, it may consequently mean that the proportion of imbalanced subjects in women was also higher. This difference in sagittal imbalance between men and women may account for the difference in pelvic incidence, which is consistent with findings from a study by Lee et al [ 17 ], which states that pelvic incidence was higher in cases with worse sagittal imbalance.…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies of sagittal spinal balance have reported conflicting results about its association with BMD. Lee et al [ 17 ] showed that femur neck BMD and pelvic incidence contributed significantly to sagittal balance. However, the study population included only patients with osteoporosis; it did not consider subjects with osteopenia or with normal BMD.…”

Section: Discussionmentioning

confidence: 99%

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Correlates of Bone Mineral Density and Sagittal Spinal Balance in the Aged

et al. 2015

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ObjectiveTo investigate the relationship between bone mineral density (BMD) and sagittal spinal balance in the Korean elderly population.MethodsThe retrospective study included subjects aged 60 years and above, who had whole-spine lateral radiography and dual-energy X-ray absorptiometry (DEXA) within a year's gap between each other. Sagittal vertical axis (SVA) for evaluation of sagittal spinal balance and five spinopelvic parameters were measured through radiography. The presence of compression fracture was identified. Correlations of BMD T-scores with SVA and with the spinopelvic parameters were assessed using Pearson correlation coefficient (PCC). Linear regression analyses were performed between SVA and the clinical and radiologic variables.ResultsOne hundred twenty-two subjects (42 males and 80 females; mean age, 69.93±5.5 years) were included in the study. BMD, femur or spine, was not correlated with SVA or any spinopelvic parameters in both genders (PCC<±0.2), except that spine BMD in men was associated with sacral slope. Univariate regression analysis revealed association between SVA and lumbar lordosis, pelvic tilt, and compression fractures in both genders; it was also associated with age and pelvic incidence in females and with sacral slope in males. Multivariate linear regression model showed lumbar lordosis and compression fracture as variables affecting SVA in both sexes; pelvic incidence was another factor affecting SVA in women only.ConclusionBMD was not associated with sagittal spinal balance in the aged. Sagittal spinal balance was explained partly by lumbar lordosis and compression fracture. Further study is warranted to understand progression of sagittal imbalance with age.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Correlates of Bone Mineral Density and Sagittal Spinal Balance in the Aged

et al. 2015

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“…There are many advantages to a minimally invasive surgical (MIS) approach including less blood loss, lower complication rates, and improved cosmesis. [1][2][3][4][5][6][7][8][9][10] Nonetheless, widespread adoption of CMIS correction has been limited by a steep learning curve 11,12 and the relative inability to achieve a robust sagittal alignment.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Lordotic cages on creating Sagittal Balance in the CMIS treatment of Adult Spinal Deformity

Anand

Cohen

et al. 2017

Int J Spine Surg

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“…Recently, variable risk factors, as well as bone mineral density, have been investigated for osteoporotic vertebral fracture. Particullarly the spino-pelvic parameters on spinal sagittal balance have been widely studied to help understand whether or not physical posture shows and causes certain pathologies of the spine in particular degenerative diseases [ 3 , 4 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

What Is the Effect of Spino-Pelvic Sagittal Parameters and Back Muscles on Osteoporotic Vertebral Fracture?

et al. 2015

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Study DesignCase control study.PurposeTo examine the effect of spino-pelvic sagittal parameters and back muscles on osteoporotic vertebral fracture.Overview of LiteratureLow bone mass is not the only important component of the risk on osteoporotic vertebral fracture; many other risk factors also contribute to skeletal fragility.MethodsSeventy-two patients who had a lateral radiograph of the whole spine, magnetic resonance imaging of the lumbar spine, and bone densitometry, were enrolled. The spino-pelvic sagittal parameters (pelvic incidence, pelvic tilt [PT], sacral slope, thoracic kyphosis, lumbar lordosis), age, lumbar bone mineral density, and amount of back muscle around the lumbar spine were analyzed.ResultsThere was higher sagittal imbalance of the spine in the vertebral fracture group (p=0.011). In spinopelvic parameters, the average of PT was 22.13° in vertebral fracture group and 13.70° in the non-fracture group (p=0.002). The amount of lower back extensor muscle in the vertebral fracture group was 2,170 mm2, which was lower than the non-fracture group (3,040 mm2, p=0.001). Multiple logistic regression analysis for the risk of osteoporotic vertebral fracture was significant in lumbar bone mineral density (odds ratio [OR], 0.313; 95% confidence interval [CI], 0.139-0.706, p=0.005) and the muscle ratio of extensor back muscle (OR, 0.902; 95% CI, 0.826-0.984; p=0.020).ConclusionsThese results suggest that osteoporotic vertebral fracture could be developed easily by weakness of extensor back muscle in sagittal imbalance of the spine with high pelvic tilt.

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Prediction of sagittal balance in patients with osteoporosis using spinopelvic parameters

Cited by 33 publications

References 29 publications

Correlates of Bone Mineral Density and Sagittal Spinal Balance in the Aged

Correlates of Bone Mineral Density and Sagittal Spinal Balance in the Aged

The Influence of Lordotic cages on creating Sagittal Balance in the CMIS treatment of Adult Spinal Deformity

What Is the Effect of Spino-Pelvic Sagittal Parameters and Back Muscles on Osteoporotic Vertebral Fracture?

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