Clinical Study Of Prone Position Imaging Data For Osteoporotic Spinal Fracture With Kyphosis

Objective With the continuous development of population aging,the incidence of osteoporotic spinal fractures with kyphotic deformity is constantly increasing.If the early treatment is not correct or timely,the late often appear from intractable lumbar back pain,combined with spinal instability or neurological damage and even complications such as kyphosis.Currently,the degree of kyphosis of the osteoporotic fracture of the spine is evaluated based on the full-length standing lateral X-ray of spine.However,when the standing position is taken,the patient often fails to cooperate with the normal standing due to pain.The measured data may be too large to reflect the real situation,resulting in the existence of a fixed segment with a long fixed section and a high osteotomy grade.Moreover,the long-term follow-up orthopedic loss was significant.The purpose of this study was to investigate the clinical significance of prone position imaging data in guiding the operation of OVCF with kyphotic deformity.Methods Retrospective analysis of 38 patients with osteoporosis vertebral fracture with kyphosis admitted to our hospital from Apr 2016 to Feb 2019(32F,6M),with an average age of 61.5±7.5 yrs(47~75 yrs),the t-value of average BMD was-2.3±0.7(-3.7~-1.5).All patients met the inclusion criteria,preoperative bone density,standing X-ray of the spine,prosthetic full-length spinal CT,lumbar MRI were all measured,and bone density examination suggesting osteoporosis(T value <-2.5).All patients led by the same spine surgeon X-ray films of standing lateral spinal length and prone position over the spine CT positioning.All patients had a lateral LKCA of >40 ° before surgery,including 26 patients with 40°<LKCA<60° and 12 patients with LKCA>60°.The full-length CT location of the prosthetic spine was measured in 7 patients with LKCA<40 °,25 patients with 40 ° <LKCA<60 °,and 6 patients with LKCA>60 °.LKCA,TK and LL measured in the full-spine prone position compression CT were used to select surgicalplan.The LKCA < 30 ° unosteotomy was obtained;2 cases of 30 ° <prone position LKCA<40°given single segment osteotomy under grade III;25 cases of 40°<prone position LKCA<60°advanced modified grade III or IV single segment osteotomy and 6cases LKCA>60° conducted grade IV single-segment osteotomy.Results All patients successfully completed the operation and imaging data collection,and the postoperative recovery and curative effect was satisfactory.The mean follow-up was12.9 ±3.1 mhs(12 ~ 21 mhs).LKCA,TK and LL of full-length X-ray of standing lateral spine and full-length CT of prone spine were measured(table 2).Preoperative full-spine prone position compression CT was significantly smaller than that in standing lateral position(LKCA,TK and LL),and the difference between them was statistically significant(P<0.05).The LKCA,TK and LL data of the full-length lateral X-ray of the spine were compared with full-spine prone position compression CT in the preoperative position at 2 weeks after operation,and the difference was statistically significant(P<0.05).The grade of surgery can be evaluated by using the full-spine prone position compression CT like LKCA.In the last follow-up,LKCA,TK and LL of full-length standing lateral spine X-ray images showed no significant difference compared with 2 weeks after surgery(P>0.05)Conclusion The full-spine prone position compression CT can make full use of the flexibility of the spine,eliminate the compensation angle caused by the patient’s own gravity,muscle stiffness,pain,etc.And accurately assess the kyphosis of patient’s real LKCA,TK,LL with osteoporotic spinal fractures.At the same time,it can provide an important reference for surgical treatment,reduce surgical trauma,promote postoperative recovery,and has the advantages of low dose,low radiation,simple operation,low price,etc.And witch has high clinical application value and promotion significance.and promotion significance.