Prediction of sagittal balance in patients with osteoporosis using spinopelvic parameters.
OBJECTIVE
Little data is available on the relationships between sagittal balance and spinopelvic parameters in osteoporosis. We analyzed sagittal spinopelvic parameters in osteoporotic patients.


METHODS
In this prospective study, the patient and control groups comprised 124 osteoporotic patients and 40 controls. Average age was 72.4 ± 6.8 in the osteoporosis group and 42.7 ± 12.5 in the control group, which was significantly different (P < 0.001). Osteoporotic patients were allocated to two groups by sagittal vertical axis, namely, a sagittal balance group (n = 56) and a sagittal imbalance group (n = 68). All 164 study subjects underwent whole spine lateral radiography, which included hip joints. The radiographic parameters investigated were sacral slope, pelvic tilt, pelvic incidence, thoracic kyphosis, lumbar lordosis, and sagittal vertical axis. Statistical analysis was performed to identify significant differences between the two groups.


RESULTS
Osteoporotic patients and controls were found to be significantly different in terms of sagittal vertical axis, sacral slope, pelvic tilt, lumbar lordosis, and thoracic kyphosis. However, no significant difference was observed between patients and controls in terms of pelvic incidence (P > 0.05). Significant differences were found between the balance and imbalance groups in terms of age, lumbar spine bone mineral density (LSBMD), femoral neck BMD (FNBMD), visual analogue scale (VAS) score, sacral slope, and pelvic incidence. Correlation analysis revealed significant relationships between sagittal parameters and osteoporosis. Stepwise logistic regression analysis revealed that FNBMD and pelvic incidence contributed significantly to sagittal balance.


CONCLUSIONS
Sagittal spinopelvic parameters were found to be significantly different in patients and normal controls. Significant relationships were found between sagittal spinopelvic parameters in osteoporotic patients. In particular, low FNBMD and high pelvic incidence were significant parameters in determination of sagittal balance in osteoporotic patients.
Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University School of Medicine, 1-10 Ami-Dong, Seo-Gu, Busan, 602-739, Republic of Korea. jungsublee@pusan.ac.kr
Jung Sub
JS
Lee
Hong Seok
HS
Lee
Jong Ki
JK
Shin
Tae Sik
TS
Goh
Seung Min
SM
Son
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging; D008141:Lordosis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010388:Pelvis / Q000000981:diagnostic imaging*; D004856:Postural Balance / Q000502:physiology*; D011859:Radiography; D012447:Sacrum / Q000000981:diagnostic imaging; D013131:Spine / Q000000981:diagnostic imaging*