title: The correlation between vertebral wedge-shaped changes in X-ray imaging at supine and standing positions and the efficacy of operative treatment of thoracolumbar spinal fracture in the elderly.
abstract: METHODS
  By analyzing a large number of surgical patients, we identified the roles of wedge-shaped changes in related surgeries.
  
  
  OBJECTIVE
  To illustrate the relevance of vertebral wedge-shaped changes in X-ray imaging at supine and standing positions in patients with percutaneous kyphoplasty as well as the postoperative effect.
  
  
  METHODS
  All patient data were collected from a hospital in China.
  
  
  METHODS
  Between June 2006 and May 2010, 77 surgical patients (9 men and 68 women) with wedge-shaped compression fractures were retrospectively analyzed. Patients were divided into group A (ΔWR2.5%) and group B (ΔWR<2.5%) according to the dynamic changes in the percentage of vertebral body wedge-shaped variable ratio (WR) at supine and standing positions. The intensity of back pain in different positions pre- and postoperatively was evaluated with a visual analog pain scale (VAS).
  
  
  RESULTS
  The WRs in both standing and supine positions were significantly reduced by kyphoplasty in both groups A and B. In agreement with the improvement in WRs, the VAS was significantly decreased in three positions for patients in group A and in turning over and standing position for patients in group B. With respect to ΔWR changes, group B revealed significantly lower values compared with group A preoperatively (P<0.001), but there was no significant difference between groups A and B postoperatively and at 1-month follow-up (P=0.179 and P=0.558, respectively).
  
  
  CONCLUSIONS
  Improvement in symptoms after kyphoplasty is better in patients with wedge-shaped changes in supine and standing positions, and the efficacy of height restoration of the spine would be better in unstable vertebrae by balloon dilatation.
authors.affiliation: Department of Orthopedic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: L
authors.initials: L
authors.lastname: Qian
authors.forename: J
authors.initials: J
authors.lastname: Pan
authors.forename: Z D
authors.initials: ZD
authors.lastname: Liu
authors.forename: L J
authors.initials: LJ
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Tan
authors.forename: L M
authors.initials: LM
authors.lastname: Cheng
authors.forename: Z L
authors.initials: ZL
authors.lastname: Zeng
authors.forename: Y W
authors.initials: YW
authors.lastname: Jia
authors.forename: X F
authors.initials: XF
authors.lastname: Li
authors.forename: H T
authors.initials: HT
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D058498:Kyphoplasty / Q000379:methods* / Q000592:standards*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010147:Pain Measurement; D011187:Posture / Q000502:physiology*; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000601:surgery*; D016683:Supine Position / Q000502:physiology*; D013904:Thoracic Vertebrae / Q000502:physiology; D014965:X-Rays