Correlation Between The Sagittal Balance Of The Spine Pelvis In Patients With Osteoporosis Vertebral Compression Fracture And The Effect Of Vertebral Cement Augmentation

Objective1. To evaluate the effection of the sagittal balance of the spine and pelvison percutaneousvertebral augmentation(PVA).2. To analyze the corralation between pelvison percutaneousvertebral augmentation(PVA) and the specific parameters of the sagittal balance of the spine-pelvis.3. To explore the treatment method of OVCFs according to TCM theory based on the effection of sagittal balance of the spine and pelvis.Methods1. From June2011to June2013, OVCFs patients who accepted PVA in the spine department of1st hospital of Guangzhou University of TCM were reviewd.68with full pre-and post operation radiological data and questionnaires were enrolled. The patients were divided into3groups based on the Barrey’s method:Group A(maintain balance,13males and19females), Group B(maintain balance with compensation,7males and18females), Group C(imbalance,3males and8females). The following parameters were recorded in12or18months follow-up:VAS pain score, Barthel index, Berg index, new OVCFs or height loss of augmented vertebra.2. Cobb angle of the fractured vertebrae, thoracic kyphosis(TK), thoracolumbar kyphosis(TLK), lumbar lordosis(LL), sacral slope (ss), pelvic tilt(PT) and pelvic incidence(PI) were recorded for relative analysis of correlations between pelvison percutaneousvertebral augmentation(PVA) and the specific parameters of the sagittal balance of the spine-pelvisResults1. Group A showed significantly better VAS and ADL improvements than Group B and C (P<0.05); Group B were better than Group C (P<0.05); Patients in Group A and B showed better ability to maintain sagittal balance than Group C (P<0.05)2. The incidence of new OVCF in group A(4/32) were significantly lower than those in Group B(8/25) and C(5/11). The recollapse of augmented vertebra in Group A (0/32) were also significantly lower than those in Group B (3/25) and C (2/11).3. LL and SS will be adjusted to the increase of Cobb angle of the fractured vertebra and TLJ/TK, the increase of LL in Group B were equal to the increase of Cobb angle and TLI. SS and PT had a negative correlation with Cobb angle, TK and TLI, while no linear correlation were founded. In group C, the increase of LL was less than the increase of Cobb angle and TLI, it was possibly caused by sagittal imbalance.Conclusion1. The sagittal balance of the spine and pelvis are significantly related to the results of PVA on OVCFs. Sagittal imbalance can induce postoperative pain and reduce the ability to perform daily activities.2. Abnormal sagittal balance of the spine and pelvis may predict adjacent OVCFs, recollapse of augmented vertebrae.3. The compensation to maintain the sagittal balance were based more on spine, the LL were key roles in maintenance of the sagittal balance of the spine-pelvis in OVCFs patients.4. TCM theory should be emphisized in the treatment of OVCFs.