Clinical Study On The Full-length CT Compression Image Of Spine In Prone In The Correction Of Old Osteoporotic Spinal Fractures With Moderate And Severe Kyphosis

Objective With the progress of population aging,the incidence of elderly patients with osteoporotic vertebral compression fractures is increasing year by year.When they are not treated in time or treated improperly,progressively worsening kyphotic deformities often occur,leading to the forward shift of the trunk gravity line.Combined with intractable low back pain,surgical correction is often needed to relieve pain,rebuild sagittal balance and improve quality of life.At present,it has been clinically reported that The Full-length CT Compression Image of Spine in Prone is useful for guiding the correction of osteoporotic spine fractures with kyphosis.However,for such patients,whether to cut the bone and explore the flexibility and correction rate of kyphosis The correlation has not been reported in the literature.According to clinical practice,we take the local kyphosis Cobb angle of the spine measured by the full-length prone position CT image to more accurately assess the degree of kyphosis and the flexibility of the spine,to guide the selection of surgical options and predict the effect of postoperative correction.To explore the significance of the Full-length CT Compression Image of Spine in Prone in the correction of old osteoporotic spine fractures with moderate to severe kyphosis.Methods A retrospective analysis of 34 cases of old osteoporotic spine fractures with moderate to severe kyphotic deformity who underwent posterior spinal deformity correction surgery in our hospital from December 2016 to June 2019,including 5 males and 29 females;The age is 55-75 years old,with an average of 64.8 years old.The course of illness was from 8 to 30 months,with an average of 18.5 months.According to the osteotomy,they were divided into non-osteotomy group(9 cases)and osteotomy group(25 cases).The age,gender,and full-length compression CT of prone spine of the two groups were statistically analyzed to measure local kyphosis cobb Angle(LKCA),kyphosis flexibility(KF),full-length lateral X-ray of the standing spine,local kyphotic Cobb angle,2 weeks postoperative and last follow-up,standing local kyphosis Cobb angle,preoperative,Three months after surgery and the final follow-up,the visual analogue scale(VAS)and Oswestry disability index(ODI),intraoperative blood loss,operation time,fixed segment,and osteotomy level were used;correlation Analyze and explore the correlation between kyphosis flexibility and correction rate(CR).Results There was no significant difference between the two groups in age,gender composition,and preoperative standing LKCA(p>0.05).The preoperative LKCA and KF differences in the prone position were statistically significant(P<0.05).Intraoperative blood loss,operation time,and number of fixed segments in the osteotomy group were higher than those in the non-osteotomy group(p<0.05);the standing LKCA in the two groups was significantly improved 2 weeks after the operation compared with before the operation(p<0.05),and there was no significant difference in the last follow-up Orthosis was lost;the VAS score and ODI score at the last follow-up were significantly improved compared to before surgery.In the non-osteotomy group,KF and CR were(0.47±0.05)and(0.65±0.09),respectively.KF and CR were significantly correlated(r =-0.685,P <0.05);KF and CR in the osteotomy group were(0.34±0.10),(0.61±0.13),there is no correlation between the two(r=0.330,P>0.05).Conclusion Preoperative the Full-length CT Compression Image of Spine in Prone can guide the selection of surgical options for old osteoporotic spine fractures with moderate to severe kyphosis.For the non-osteotomized group,the postoperative correction effect can be predicted based on the flexibility of the spine.