The Effect Of Sagittal Balance On The Functional Recovery Of Postoperative Patients With PVP

Objective There are many reasons for the imbalance of the spine and pelvis,including osteoporotic vertebral compression fractures caused by osteoporosis(thoracic and lumbar fractures),severe damage to the spine and pelvis can destroy the sagittal balance of the spine and pelvis,in order to balance the balance of the spine and pelvis,which is caused by the above reasons,it is widely used in the clinic to reconstruct the balance of the vertebral body,especially the sagittal balance.By comparing the difference of the parameters of spine and pelvis sagittal balance and related scale value in the patients with PVP before and after operation,and to explore the influence of sagittal balance reconstraction on the functional recovery of patients after PVP.Methods A retrospective analysis of 52 cases(12 males,40 females,average age 68.25 years old,age random from 58~85)who received PVP operation and contrast before and after value changes of operation such as cervical lordosis(CL),thoracic kyphosis(TK),lumbar lordosis(LL),spinal sagittal balance(SVA),pelvic incidence(PI),pelvic tilt(PT),sacral inclination angle(SS),the difference of low back pain JOA score,Oswestry score,VAS score and other indicators of the spine,of the 52 cases treated with PVP,21 thoracic fractures,31 thoracolumbar fractures,accordance with a predetermined prospective study plan from spine orthopaedic of Yijishang hospital of Wannan medical college from April 2014~September 2015.Results The operation of the 52 cases were successful with no one died in the process of sergery and perioperation.All cases with a followed-up for 1~6 months,average 4.5 months.Preoperative CL9.212°±30.499° ? TK41.385°±27.957° ?LL59.135°±36.367° ? SVA20.692mm±85.861 mm ? PI71.614°±35.303° ?PT30.635°±19.811° ? SS54.700°±31.944° ? JOA 8.385±2.162 ? Oswestry 34.808±3.042 ? VAS 6.808±0.971 ? Postoperative CL9.077°±16.384° ?TK24.635°±13.233° ? LL42.865°±8.765° ? SVA-20.962mm±47.397 mm ?PI38.173°±7.326°? PT14.000°±3.492°? SS34.519°±5.497°? JOA 24.058±2.118 ?Oswestry 12.539±1.787?VAS 1.712±0.696.There was no significant difference in CL value between the sagittal parameters of spine and pelvis before and after operation(P>0.05);The results of TK,LL,SVA,PI,PT and SS after operation were significantly different from those before operation(P <0.05);VAS,JOA score,ODI score and preoperative comparison was statistically significant(P <0.05);CL,PI and PT were closely related(P<0.01,CL vs PI;P<0.05,CL vs PT);TK was closelyrelated to PT(P <0.01);PI was closely correlated to PT(P<0.01).Conclusions The spine balance includes horizontal,coronal and sagittal balance,because the human spinal physiological curvature,the spinal sagittal balance in the maintenance of normal body posture plays an extremely important role;As a whole,the structural damage and destruction of either side will lead to the change of a series of spinal sagittal parameters;Due to various causes of the spine pelvis sagittal imbalance,the use of percutaneous vertebroplasty to reconstruct the balance of the spine pelvis can achieve good clinical efficacy,it is not only shown that the relative parameters are restored to normal or near normal,but also to the improvement of the relevant assessment scale;Reconstruction of sagittal parameters of spine and pelvis plays an important role in the improvement of postoperative recovery and quality of life after PVP operation,clinicians should pay more attention to the evaluation system of spine pelvis sagittal parameters in clinical application.