Skip to main content
Top
Published in: European Spine Journal 12/2014

01-12-2014 | Original Article

Predictors of kyphotic deformity in osteoporotic vertebral compression fractures: a radiological study

Authors: Sanganagouda Patil, Abhay M. Nene

Published in: European Spine Journal | Issue 12/2014

Login to get access

Abstract

Purpose

To report the radiological predictors of kyphotic deformity in osteoporotic vertebral compression fractures (OVCF).

Methods

This is a retrospective study of 64 consecutive patients with OVCF. We studied the radiographic features in the immediate post-injury image of patients, who developed significant (more than 30°) segmental kyphotic deformity at final follow-up and compared them with those patients who did not.

Results

Thirty-three (82.5 %) out of 40 patients with fracture at thoracolumbar (TL) junction, 5 (33.3 %) patients out of 15 with fracture at lumbar (L) spine and 7 (77.7 %) patients out of 9 with fracture at thoracic (T) spine developed significant segmental kyphotic deformity. Forty-one (75.9 %) [TL-33 (80.5 %), L-4 (33.33 %) and T-4 (80 %)] out of 54 [TL-37 (68.51 %), L-12 (22.23 %) and T-5 (9.26 %)] patients with superior endplate fracture developed significant segmental kyphotic deformity. Forty patients (86.9 %) [TL-28 (70 %), L-6 (15 %) and T-6 (15 %)] out of 46 [TL-32 (69.56 %), L-8 (17.4 %) and T-6 (13.04 %)] with anterior cortical wall fracture developed significant segmental kyphotic deformity. Five patients (71.42 %) [TL-2 (40 %) and T-3 (60 %)] out of 7 [TL-02 (28.58 %), L-01 (14.28 %), T-04 (57.14 %)] with adjacent level fracture developed significant segmental kyphotic deformity. The average immediate post-injury kyphosis of 11° (5°–25°) increased to 29° (15°–50°) at final follow-up.

Conclusion

Progressive segmental kyphotic collapse following an OVCF seems unavoidable. Patients with TL junction and superior endplate fracture are probably at the highest risk for significant segmental kyphotic deformity.
Literature
1.
go back to reference Chang Kao-Wha, Chen Ying-Yu, Lin Chien-Chung, Hsu Hsiang-Lan, Pai Ke-Chun (2005) Apical lordosating osteotomy and minimal segment fixation for the treatment of thoracic or thoracolumbar osteoporotic kyphosis. Spine 30:1674–1681PubMedCrossRef Chang Kao-Wha, Chen Ying-Yu, Lin Chien-Chung, Hsu Hsiang-Lan, Pai Ke-Chun (2005) Apical lordosating osteotomy and minimal segment fixation for the treatment of thoracic or thoracolumbar osteoporotic kyphosis. Spine 30:1674–1681PubMedCrossRef
2.
go back to reference Brian K Alldredge, Koda-Kimble, Anne Mary, Young, Y Lloyd, Wayne A Kradjan, Joseph Guglielmo B (2009) Applied therapeutics: the clinical use of drugs. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, pp 101–103 Brian K Alldredge, Koda-Kimble, Anne Mary, Young, Y Lloyd, Wayne A Kradjan, Joseph Guglielmo B (2009) Applied therapeutics: the clinical use of drugs. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia, pp 101–103
3.
go back to reference WHO (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 843:1–129 WHO (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 843:1–129
4.
go back to reference Tsujio T, Nakamura H, Terai H, Hoshino M, Namikawa T, Matsumura A, Kato M, Suzuki A, Takayama K, Fukushima W, Kondo K, Hirota Y, Takaoka K (2011) Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion a prospective multicenter study. Spine 36:1229–1235PubMedCrossRef Tsujio T, Nakamura H, Terai H, Hoshino M, Namikawa T, Matsumura A, Kato M, Suzuki A, Takayama K, Fukushima W, Kondo K, Hirota Y, Takaoka K (2011) Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion a prospective multicenter study. Spine 36:1229–1235PubMedCrossRef
5.
go back to reference Belmont PJ Jr, Polly DW Jr, Cunningham BW et al (2001) The effects of hook pattern and kyphotic angulation on mechanical strength and apical rod strain in a long-segment posterior construct using a synthetic model. Spine 26:627–635PubMedCrossRef Belmont PJ Jr, Polly DW Jr, Cunningham BW et al (2001) The effects of hook pattern and kyphotic angulation on mechanical strength and apical rod strain in a long-segment posterior construct using a synthetic model. Spine 26:627–635PubMedCrossRef
6.
go back to reference White AA, Panjabi MM, Thomas CL (1977) The clinical biomechanics of kyphotic deformities. Clin Orthop Relat Res 128:8–17PubMed White AA, Panjabi MM, Thomas CL (1977) The clinical biomechanics of kyphotic deformities. Clin Orthop Relat Res 128:8–17PubMed
7.
go back to reference Heggeness MH (1993) Spine fracture with neurological deficit in osteoporosis. Osteoporos Int 3:215–221PubMedCrossRef Heggeness MH (1993) Spine fracture with neurological deficit in osteoporosis. Osteoporos Int 3:215–221PubMedCrossRef
8.
go back to reference Salomon C, Chopin D, Benoist M (1988) Spinal cord compression: an exceptional complication of spinal osteoporosis. Spine 13:222–224PubMedCrossRef Salomon C, Chopin D, Benoist M (1988) Spinal cord compression: an exceptional complication of spinal osteoporosis. Spine 13:222–224PubMedCrossRef
9.
go back to reference Roush RN, Karen MSN, FNP BC (2011) Prevention and treatment of osteoporosis in postmenopausal women: a review. Am J Nurs 111:26–35PubMedCrossRef Roush RN, Karen MSN, FNP BC (2011) Prevention and treatment of osteoporosis in postmenopausal women: a review. Am J Nurs 111:26–35PubMedCrossRef
10.
go back to reference Adams MA, Freeman BJ, Morrison HP, Nelson IW, Dolan P (2000) Mechanical initiation of intervertebral disc degeneration. Spine 25:1625–1636PubMedCrossRef Adams MA, Freeman BJ, Morrison HP, Nelson IW, Dolan P (2000) Mechanical initiation of intervertebral disc degeneration. Spine 25:1625–1636PubMedCrossRef
11.
go back to reference Pollintine P, Przybyla AS, Dolan P, Adams MA (2004) Neural arch load-bearing in old and degenerated spines. J Biomech 37:197–204PubMedCrossRef Pollintine P, Przybyla AS, Dolan P, Adams MA (2004) Neural arch load-bearing in old and degenerated spines. J Biomech 37:197–204PubMedCrossRef
12.
go back to reference Edwards WT, Zheng Y, Ferrara LA, Yuan HA (2001) Structural features and thickness of the vertebral cortex in the thoracolumbar spine. Spine 26:218–225PubMedCrossRef Edwards WT, Zheng Y, Ferrara LA, Yuan HA (2001) Structural features and thickness of the vertebral cortex in the thoracolumbar spine. Spine 26:218–225PubMedCrossRef
13.
go back to reference Ortiz AO, Bordia R (2011) Bordia Injury to the vertebral endplate-disk complex associated with osteoporotic vertebral compression fractures. AJNR 32:115–120PubMed Ortiz AO, Bordia R (2011) Bordia Injury to the vertebral endplate-disk complex associated with osteoporotic vertebral compression fractures. AJNR 32:115–120PubMed
14.
go back to reference Trout AT, Kallmes DF, Layton KF, Thielen KR, Hentz JG (2006) Vertebral endplate fractures: an indicator of the abnormal forces generated in the spine after vertebroplasty. J Bone Miner Res 21:1797–1802PubMedCrossRef Trout AT, Kallmes DF, Layton KF, Thielen KR, Hentz JG (2006) Vertebral endplate fractures: an indicator of the abnormal forces generated in the spine after vertebroplasty. J Bone Miner Res 21:1797–1802PubMedCrossRef
15.
go back to reference Zhao F-D, Pollintinec P, Hole BD, Adams MA, Dolan P (2009) Vertebral fractures usually affect the cranial endplate because it is thinner and supported by less-dense trabecular bone. Bone 44:372–379PubMedCrossRef Zhao F-D, Pollintinec P, Hole BD, Adams MA, Dolan P (2009) Vertebral fractures usually affect the cranial endplate because it is thinner and supported by less-dense trabecular bone. Bone 44:372–379PubMedCrossRef
16.
go back to reference Brinckmann P, Biggemann M, Hilweg D (1988) Fatigue fracture of human lumbar vertebrae. Clin Biomech 3(Suppl 1):1–23 Brinckmann P, Biggemann M, Hilweg D (1988) Fatigue fracture of human lumbar vertebrae. Clin Biomech 3(Suppl 1):1–23
17.
go back to reference Pal GP, Cosio L, Routal RV (1988) Trajectory architecture of the trabecular bone between the body and the neural arch in human vertebrae. Anat Rec 222:418–425PubMedCrossRef Pal GP, Cosio L, Routal RV (1988) Trajectory architecture of the trabecular bone between the body and the neural arch in human vertebrae. Anat Rec 222:418–425PubMedCrossRef
18.
go back to reference Yuan HA, Brown CW, Phillips FM (2004) Osteoporotic spinal deformity: a biomechanical rationale for the clinical consequences and treatment of vertebral body compression fractures. J Spinal Disod Tech 17:236–242CrossRef Yuan HA, Brown CW, Phillips FM (2004) Osteoporotic spinal deformity: a biomechanical rationale for the clinical consequences and treatment of vertebral body compression fractures. J Spinal Disod Tech 17:236–242CrossRef
19.
go back to reference Ryu CW, Han H, Lee YM, Lim MK (2009) The intravertebral cleft in benign vertebral compression fracture: the diagnostic performance of non-enhanced MRI and fat-suppressed contrast-enhanced MRI. Br J Radiol 82:976–981PubMedCentralPubMedCrossRef Ryu CW, Han H, Lee YM, Lim MK (2009) The intravertebral cleft in benign vertebral compression fracture: the diagnostic performance of non-enhanced MRI and fat-suppressed contrast-enhanced MRI. Br J Radiol 82:976–981PubMedCentralPubMedCrossRef
20.
go back to reference Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ 3rd (1992) Incidence of clinically diagnosed vertebral fractures. A population based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227PubMedCrossRef Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ 3rd (1992) Incidence of clinically diagnosed vertebral fractures. A population based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227PubMedCrossRef
Metadata
Title
Predictors of kyphotic deformity in osteoporotic vertebral compression fractures: a radiological study
Authors
Sanganagouda Patil
Abhay M. Nene
Publication date
01-12-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 12/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3457-x

Other articles of this Issue 12/2014

European Spine Journal 12/2014 Go to the issue