title: Does spinopelvic alignment affect the union status in thoracolumbar osteoporotic vertebral compression fracture?
abstract: OBJECTIVE
  In the healing of osteoporotic vertebral fracture, global spinal mal-alignment might increase the load sharing at the fracture site and deteriorate the fracture healing. This study aimed to evaluate the effect of spinopelvic alignment on the union status of thoracolumbar osteoporosis-related vertebral compression fracture (OVCF).
  
  
  METHODS
  Consecutive 48 patients with a single-level thoracolumbar fresh OVCF were treated non-operatively. Union was judged by three independent observers at 6 months, and patients were divided into union group and non-union group. Spinopelvic alignment was measured using upright whole spine radiograph before treatment as follows: pelvic incidence (PI), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), sagittal vertical axis (SVA), and DSVA, defined as the distance from a plumb line dropped from the center of the C7 body to the center of fractured vertebral body.
  
  
  RESULTS
  Global spinal alignment was different in union group and non-union group: SVA (4.7 ± 0.7 cm in union group vs. 8.9 ± 1.3 cm in non-union group, P = 0.007), DSVA (4.2 ± 0.6 cm in union group vs. 9.5 ± 1.0 cm in non-union group, P < 0.001), and PI-LL (18.9° ± 2.2° in union group vs. 30.3° ± 3.9° in non-union group, P = 0.014). Over 5 cm of DSVA [P = 0.022, adjusted odds 7.9 (95 % CI 1.3-77.0)] and/or over 30° of PI-LL [P = 0.026, adjusted odds 6.6 (95 % CI 1.5-44.2)] showed the significant risk factors for non-union using multivariate logistic regression analysis in the other background status.
  
  
  CONCLUSIONS
  Global spinal mal-alignment, showing over 5 cm of DSVA and/or over 30° of PI-LL, affected the union status of OVCF.
authors: Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan. iwataakira0126@yahoo.co.jp.|Department of Orthopaedic Surgery, Hokkaido University School of Medicine, N15 W7 Kita-Ward, Sapporo, Hokkaido, 060-8638, Japan. iwataakira0126@yahoo.co.jp.
authors: Akira
authors: A
authors: Iwata
authors: Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
authors: Masahiro
authors: M
authors: Kanayama
authors: Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
authors: Fumihiro
authors: F
authors: Oha
authors: Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan.
authors: Tomoyuki
authors: T
authors: Hashimoto
authors: Department of Orthopaedic Surgery, Hokkaido University School of Medicine, N15 W7 Kita-Ward, Sapporo, Hokkaido, 060-8638, Japan.
authors: Norimasa
authors: N
authors: Iwasaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017760:Bone Malalignment / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D017102:Fracture Healing / Q000502:physiology*; D050815:Fractures, Compression / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000503:physiopathology / Q000628:therapy*; D016103:Spinal Fractures / Q000503:physiopathology / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000293:injuries; D016896:Treatment Outcome
keywords: DSVA; Osteoporotic vertebral fracture; Risk factors; Spinopelvic alignment; Union status