Kyphoplasty Restores the Global Sagittal Balance of the Spine Independently from Pain Reduction

Pumberger, Matthias; Schitz, Florian; Bürger, Justus; Schömig, Friederike; Putzier, Michael; Palmowski, Yannick

doi:10.1038/s41598-020-65798-0

Cited by 17 publications

(5 citation statements)

References 22 publications

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“…Good repositioning of the local deformation has been shown to be directly correlated to the correction of the global sagittal profile of the spine and is therefore fundamental for a positive clinical outcome. 19 In the OF 2 group, there was a small restoration of the vertebral body height in the anterior and middle portion, which was however much lower than for the other 2 groups and did not result in a relevant improvement of LKA. This is in line with the recommendation by the developers of the OF classification, who recommend a primarily conservative treatment in patients with OF 2 fractures.…”

Section: Discussionmentioning

confidence: 73%

Relationship Between the OF Classification and Radiological Outcome of Osteoporotic Vertebral Fractures After Kyphoplasty

Palmowski

Balmer

et al. 2020

Global Spine Journal

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Study Design: Retrospective cohort study. Objectives: The OF classification is a new classification for osteoporotic vertebral fractures. The aim of this study was to clarify the relationship between preoperative OF subgroups and the postoperative outcome after kyphoplasty in patients with such fractures. Methods: Patients who underwent kyphoplasty of a single osteoporotic vertebral fracture were included and divided into groups according to the OF subgroups. Pre- and postoperative plain radiographs were analyzed in regard to the restoration of vertebral body height and local kyphotic angle (LKA). Additionally, clinical data including pre- and postoperative Visual Analogue Scale pain scores was documented. The clinical and radiological results were compared pre- and postoperatively within groups and between groups. Results: A total of 156 patients from OF subgroups 2 to 4 were included (OF 2: n = 58; OF 3: n = 36; OF 4: n = 62). Patients from all groups experienced significant pain relief postoperatively ( P < .001). Patients with OF 2 fractures showed a repositioning of the vertebral body height in the anterior and middle portions (both P < .001), but no significant improvement in LKA. For OF 3 and 4 fractures, there was a significant restoration of vertebral body height ( P < .001 for both) and a significant improvement of LKA ( P < .001 for both). The highest average restoration was noted in the OF 4 group. Conclusions: A higher OF subgroup is related to a higher radiological benefit from kyphoplasty. This confirms that the OF classification is an appropriate tool for the preoperative assessment of osteoporotic fractures.

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Section: Discussionmentioning

confidence: 73%

Relationship Between the OF Classification and Radiological Outcome of Osteoporotic Vertebral Fractures After Kyphoplasty

Palmowski

Balmer

et al. 2020

Global Spine Journal

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“…The wedge angle also decreased, improving coronal alignment [ 9 ]. By restoring vertebral height, sagittal balance is also improved in cases of kyphotic deformity [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

Nikolaou,

Chatzikomninos,

Tournis

et al. 2023

Cureus

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Low-impact spinal fractures in young patients are rare and should raise suspicion of an underlying condition, as these injuries are typically the result of high-energy trauma. We describe a case of a young male patient who sustained a burst fracture of the first lumbar vertebra (L1) following low-energy trauma. The patient underwent percutaneous posterior spinal instrumentation, yet the poor bone quality detected intraoperatively prompted further diagnostic evaluation. Subsequently, low bone mineral density (BMD) was detected, and a rare plastine-3 (PLS3) gene mutation was revealed in the genetic analysis. The patient was initiated on teriparatide therapy after the discovery of osteoporosis postoperatively. It is, therefore, imperative to investigate all young patients with low-energy spinal fractures preoperatively to discover the underlying pathology promptly.

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“…Kyphoplasty application induces the forward displacement of the SVA and enables sagittal balance by fixing the kyphotic deterioration by providing bone restoration of sagittal deformities [9]. Postoperative recovery in SVA following kyphoplasty is also associated with the correction of this angulation [10]. Particularly kyphoplasty ameliorates the condition also has favorable effects on the sagittal parameters to be obtained [22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Vertebroplasty on Sagittal Parameters in Traumatic Thoracic Vertebral Fractures

Kemal

2022

Int Arch Orthop Surg

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Objective: It is well-established that vertebroplasty has effects on sagittal parameters due to various pathologies of the spine. Our objective in the study was to reveal the impact of vertebroplasty that was applied to compression fractures due to trauma on sagittal parameters. Material and method:Fourteen patients with the injury score > 4, based on the thoracolumbar injury classification score (TLICS), and with type A fractures, based on the AO Spine thoracolumbar injury classification score (TLAOSIS), were included in the study. Scoliosis radiographs were shot preoperatively and at 1 st , 6 th , and 12 th months during the postoperative period, and measurements were performed using the software of Surgimap (Nemaris, Inc). Spinopelvic parameters of each patient including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TC), thoracolumbar kyphosis (TLC), cervical lordosis (CL), and sagittal vertical axis (SVA) were assessed. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) assessments of the patients were performed as well. Moreover, health-related quality of life was assessed with the Medical Outcome Study Short Form-36 prior to surgery and in the 1 st month following the surgery.Results: Spinopelvic parameter values of the patients were assessed statistically through the analysis of the Friedman test before surgery, and in the 1 st month, 6 th month, and 12 th month during the postoperative period. It was found out that the changes in the pelvic tilt and sacral slope values of the patients between preoperative and 1 st month, 6 th month and 12 th month, 1 st month and 6 th month, 1 st month and 12 th month, 6 th month and 12 th month were at the level of p = 0.37, and the changes were not significant. The change in lumbar lordosis value was p < 0.01 and was significant. The changes in thoracolumbar kyphosis values at preoperative and 1st month, preoperative and 6th month, as well as preoperative and 12 th month, were p < 0.001, and the changes were significant. The changes in thoracic kyphosis values between preoperative and 1 st month, preoperative and 6 th month, as well as preoperative and 12 th month, were at the level of p < 0.001 and the changes were significant. The changes in cervical lordosis and sagittal vertical axis values at preoperative and 1 st month, preoperative and 6 th month, as well as preoperative and 12 th month, were at p = 0.002 and p < 0.001, respectively, and they were significant. Statistical analysis of the values of the Visual Analog Scale and Oswestry Disability Index Medical Outcome Study Short Form-36 life quality scale was p < 0.001, based on the results of the Friedman test, and significant. Conclusion:Vertebroplasty is an efficient technique for relieving pain in thoracic fractures that have a score of 4 and over, based on the thoracolumbar injury classification score (TLICS), and that are type A, based on the AO Spine thoracolumbar injury classification score (TLAOSIS). Elimination of pain in the acute perio...

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Kyphoplasty Restores the Global Sagittal Balance of the Spine Independently from Pain Reduction

Cited by 17 publications

References 22 publications

Relationship Between the OF Classification and Radiological Outcome of Osteoporotic Vertebral Fractures After Kyphoplasty

Relationship Between the OF Classification and Radiological Outcome of Osteoporotic Vertebral Fractures After Kyphoplasty

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

The Impact of Vertebroplasty on Sagittal Parameters in Traumatic Thoracic Vertebral Fractures

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