The Reasons Of The Spinal Sagittal Imbalance In Patients With Osteoporosis Vertebral Compression Fractures

AbstractBACKGROUND:Currently, spinal sagittal imbalance has become a common clinical disease, but also multiple diseases, spinal imbalance summary of reasons, including domestic and spinal deformity (congenital or acquired factors lead to kyphois and scoliosis or nerve muscle diseases caused by power kyphosis and scoliosis), spinal degenerative disease (lumbar disc herniation, lumbar spinal stenosis, spinal infection, spinal tumors), osteoporotic vertebral compression fractures, etc, through clinical research, We believe that the power factor (back muscle) in spinal sagittal imbalance plays a key role, which are rarely reported in domestic and aboard.OBJECTIVE:By osteoporotic vertebral compression fractures in patients with clinical manifestations and treatment, Analyze and summarize the reasons of the spinal sagittal imbalance.METHODS:A retrospective analysis of patients treated between January2012to May2013of127cases of spinal fractures, Selecting diagnosed osteoporotic compression fractures and having spinal sagittal imbalance symptoms of41patients, All patients were performed PKP surgery.9males and32females, average65.8. The patients were grouped according to preoperative and postoperative, patients underwent preoperative bone density, standing full-spine lateral X-ray, with injured vertebrae as the center of CT and MR imaging in the preoperative and postoperative standing whole spine lateral film measurement in patients with injured vertebrae anterior height, kyphosis Cobb angle and improve the angle, the angle of the injured vertebral wedging angle and improvement, requiring the patient to walk experiments and TLS (timed load standing), and postoperative relative ratio. Use Spss105.0software to establish a database and the results were descriptive statistics.The methods of statistical analysis:preoperative and postoperative study group using paired t test, P<0.05was considered statistically significant.RESULTS:preoperative patients with spinal sagittal imbalance symptoms average walking distance is514±109.86m, patients are not appearing the spinal sagittal imbalance symptoms when they walked the same distance,walking an average distance of985.62±131.51m. The difference was statistically significant (P<0.05), preoperative appearing the spinal sagittal imbalance symptoms TLS average time:10.63±2.91min, postoperative:27.56±6.32min, the difference was statistically significant (P<0.05), in the X-ray, the average difference Cobb angle was:10.01±0.76°,vertebral wedging improvement of the mean difference:4.84±0.40°, the difference was statistically significant (P<0.05). All patients were followed up for low back pain patients and sagittal imbalance symptoms were relieved. All of the patients with no serious complications after the operation.CONCLUSION AND SIGNIFICANCE:Patients with osteoporosis compression fractures can appear the symptoms of spinal sagittal imbalance, Walking or after loading can not support the back, in the process of walking or load bending symptoms, imaging performance:kyphosis cobb angle increases, The C7plumb line S1trailing edge distance increases, after PKP, kyphosis cobb angle and injured vertebral wedging angle has changed, but the change in kyphosis cobb angle was significantly greater than wedging angle changes, indicating that injured vertebral wedging is not a single factor in patients with spinal sagittal imbalance, and by percutaneous balloon kyphoplasty surgery expansion, imbalance and the symptoms tend to be significantly improved, through this phenomenon shows that back pain after spinal fracture limit back muscle strength is an important cause of spinal sagittal imbalance.