title: Improvement of spinal alignment and quality of life after corrective surgery for spinal kyphosis in patients with osteoporosis: a comparative study with non-operated patients.
abstract: This study evaluated changes in spinal alignment and quality of life (QOL) after corrective spinal surgery for patients with postmenopausal osteoporosis and spinal kyphosis. Spinal global alignment and QOL were significantly improved after corrective spinal surgery but did not reach the level of non-operated controls.
  
  
  BACKGROUND
  With the increased aging of society, the demand for corrective spinal instrumentation for spinal kyphosis in osteoporotic patients is increasing. However, previous studies have not focused on the improvement of quality of life (QOL) after corrective spinal surgery in patients with osteoporosis, compared to non-operated control patients. The purposes of this study were thus to evaluate changes in spinal alignment and QOL after corrective spinal instrumentation for patients with osteoporosis and spinal kyphosis and to compare these results with non-operated patients.
  
  
  METHODS
  Participants comprised 39 patients with postmenopausal osteoporosis ≥50 years old who underwent corrective spinal surgery using multilevel posterior lumbar interbody fusion (PLIF) for symptomatic thoracolumbar or lumbar kyphosis, and 82 age-matched patients with postmenopausal osteoporosis without prevalent vertebral fractures. Spinopelvic parameters were evaluated with standing lateral spine radiography, and QOL was evaluated with the Japanese Osteoporosis QOL Questionnaire (JOQOL), SF-36, and Roland-Morris Disability Questionnaire (RDQ).
  
  
  RESULTS
  Lumbar kyphosis angle, sagittal vertical axis, and pelvic tilt were significantly improved postoperatively. QOL evaluated with all three questionnaires also significantly improved after 6 months postoperatively, particularly in domain and subscale scores for pain and general/mental health. However, these radiographic parameters, total JOQOL score, SF-36 physical component summary score, and RDQ score were significantly inferior compared with non-operated controls.
  
  
  CONCLUSIONS
  The results indicate that spinal global alignment and QOL were significantly improved after corrective spinal surgery using multilevel PLIF for patients with osteoporosis and spinal kyphosis but did not reach the level of non-operated controls.
authors.affiliation: Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. miyakosh@doc.med.akita-u.ac.jp.
authors.forename: N
authors.initials: N
authors.lastname: Miyakoshi
authors.affiliation: Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hongo
authors.affiliation: Department of Orthopedic Surgery, Akita Kousei Medical Center, 1-1-1 Iijima-Nishifukuro, Akita, 011-0948, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopedic Surgery, Akita Kousei Medical Center, 1-1-1 Iijima-Nishifukuro, Akita, 011-0948, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Orthopedic Surgery, Akita Kousei Medical Center, 1-1-1 Iijima-Nishifukuro, Akita, 011-0948, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Abe
authors.affiliation: Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D058866:Osteoporotic Fractures / Q000150:complications / Q000000981:diagnostic imaging; D011594:Psychometrics; D011788:Quality of Life; D011859:Radiography; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging; D013123:Spinal Fusion / Q000379:methods / Q000534:rehabilitation; D016896:Treatment Outcome
keywords: Kyphosis; Osteoporosis; Posterior lumbar interbody fusion; Quality of life; Spinal instrumentation