The Clinical Relevance of Hyperkyphosis: A Narrative Review

Koelé, Marije C.; Lems, W.F.; Willems, Hanna C.

doi:10.3389/fendo.2020.00005

Cited by 56 publications

(65 citation statements)

References 71 publications

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“…Although thoracic and thoracolumbar hyperkyphosis increases the risk of future spine fracture in patients with previous fractures [24], the neutral posture for radiographic evaluation may be insu cient to describe the internal mechanical state of vertebral compression fractures. Previous studies ran a spinal simulation in vertical and neutral mechanical states, but most low-energy spinal injuries are caused in the lumbar hyper exion posture [9,10].…”

Section: Resultsmentioning

confidence: 99%

Dynamic spine hyperflexion is related to vertebral compression fractures in postmenopausal women

Zheng

Tian²,

Liu

et al. 2021

Preprint

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Background: Previous studies on osteoporotic vertebral fractures are usually based on the neutral posture of the spine; however, the fractures are usually associated with the curvature of the spine. Therefore, we aimed to ascertain the relationship between vertebral compression fractures and thoracolumbar hyperflexion Cobb angles (TLHCobb) and determine the clinical cut-off of the TLHCobb angle.Methods: In this retrospective case-control study, TLHCobbs were collected from 154 postmenopausal women with thoracolumbar fractures (study group) and 310 postmenopausal women with lumbar instability or spondylolisthesis (control group). Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compared between the groups. Chi-squared tests and unpaired t-tests were used to assess the group characteristics and proportions. Logistic regression was used to examine the association between vertebral compression fractures and TLHCobb.Results: Fracture prevalence was higher in the higher TLHCobb study group than that in the control group [OR = 2.81 (2.15–3.67)] after adjusting for age, BMI, and QCT findings. TLHCobbs at and > 20.05° were associated with an increased fracture prevalence and ORs of 2.79 (1.82–4.27) and 4.83 (3.24–7.20), respectively. TLHCobb and QCT values differed between the study and control groups (p < 0.001 for both). There were no significant differences in body mass index (BMI), disk height, or coronal TLCobb between the two groups.Conclusion: There was an association between the prevalence of vertebral compression fractures and TLHCobbs in postmenopausal women, and a TLHCobb > 20.05° can be an indicator of vertebral fracture.

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Section: Resultsmentioning

confidence: 99%

Dynamic spine hyperflexion is related to vertebral compression fractures in postmenopausal women

Zheng

Tian²,

Liu

et al. 2021

Preprint

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“…13 Since it was hard to nd out whether a patient was known to have one of these conditions, in the absence of a complete medical history, it was di cult to differentiate. However, different studies have shown that kyphosis is also associated with a poor prognosis 17,18,19 . This could make the differentiation less relevant.…”

Section: Discussionmentioning

confidence: 99%

The Hanging Chin Sign As A Mortality Predictor In Geriatric Patients At The Emergency Department: A Retrospective Cohort Study

Huijgens¹,

Baardewijk²,

Keijsers³

2021

Preprint

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BACKGROUND: At the emergency department, there is a need for an instrument which is quick and easy to use to identify geriatric patients with the highest risk of mortality. The so- called ‘hanging chin sign’, meaning that the mandibula is seen to project over one or more ribs on the chest X-ray, could be such an instrument. This study aims to investigate whether the hanging chin sign is a predictor of mortality in geriatric patients admitted through the emergency department. METHODS: We performed an observational retrospective cohort study in a Dutch teaching hospital. Patients of ≥ 65 years who were admitted to the geriatric ward following an emergency department visit were included. The primary outcome of this study was mortality. Secondary outcomes included the length of admission, discharge destination and the reliability compared to patient-related variables and the APOP screener.RESULTS: 396 patients were included in the analysis. Mean follow up was 300 days; 207 patients (52%) died during follow up. The hanging chin sign was present in 85 patients (21%). Patients with the hanging chin sign have a significantly higher mortality risk during admission (OR 2.94 (1.61 to 5.39), p < 0.001), within 30 days (OR 2.49 (1.44 to 4.31), p = 0.001), within 90 days (OR 2.16 (1.31 to 3.56), p = 0.002) and within end of follow up (OR 2.87 (1.70 to 4.84),p < 0.001). A chest X-ray without a PA view or lateral view was also associated with mortality. This technical detail of the chest x-ray and the hanging chin sign both showed a stronger association with mortality than patient-related variables or the APOP screener. CONCLUSIONS: The hanging chin sign and other details of the chest x-ray were strong predictors of mortality in geriatric patients presenting at the emergency department. Compared to other known predictors, they seem to do even better in predicting mortality.

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“…Hyperkyphosis is present when the kyphosis angle exceeds over 50 degree. 1,2 There are several methods used to measure thoracic kyphosis. The standard method is the Cobb angle, which is measured from a lateral radiograph as the angle subtended by the vertebral endplates above and below the curve.…”

Section: Introductionmentioning

confidence: 99%

Reliability of Cobb’s Angle in a Measurement of Kyphosis – A Meta–Analysis

Vaishnavi

Preethi

Tharani

et al. 2022

Int J Life Sci Pharm Res

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This study aimed at analyzing the literature systematically on the reliability of Cobb’s angle in measurement of kyphosis. Cobb’s angle is the most widely used measurement to quantify spinal deformity. Kyphosis is the spinal disorder in which an excessive outwards of the spine results in an abnormal rounding of the upper back. Cobb’s angle used as standard measurement to determine and trackthe progression of scoliosis andkyphosis. Hence the purpose of the meta-analysis is to analyze the reliability of Cobb’s angle in a measurement of kyphosis Systematic searches in PubMed, Science direct, Google scholar, Cochrane library, Research Gate for systematic review was done. Research article and review article were selected within the published 1999 – 2020. The study design is Meta-analysis study of Analytical type. Study quality was done by PEDro Scale The study duration is about 4 months. A Meta-analysis was conducted by using Medical software to obtain a summary estimate of the standardized mean difference and 95% confidence limit. 100 articles taken for review in which finally 35 articles were summarized. Almost all the study shows that there was a highly significant difference on measurement of kyphosis using COBB’S angle. Outcome of measurement has excellent reliability with the small range of standard error of measurement. Cobb’s measurement had excellent reliability when used to measure kyphosis. The findings confirm the significance and the ease of using this method.

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The Clinical Relevance of Hyperkyphosis: A Narrative Review

Cited by 56 publications

References 71 publications

Dynamic spine hyperflexion is related to vertebral compression fractures in postmenopausal women

Dynamic spine hyperflexion is related to vertebral compression fractures in postmenopausal women

The Hanging Chin Sign As A Mortality Predictor In Geriatric Patients At The Emergency Department: A Retrospective Cohort Study

Reliability of Cobb’s Angle in a Measurement of Kyphosis – A Meta–Analysis

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