The Sagittal Alignment of Spine in Conservatively Treated Osteoporotic Compression Fractures of Thoracolumbar Junction

Lee, Seung Hyun; Yang, Jun Young; Park, Jun Yeong; Lee, June Kyu

Abstract

OBJECTIVES
To evaluate the radiological outcomes of conservative treatment for osteoporotic compression fractures in thoracolumbar junction.
MATERIALS AND METHODS
20 osteoporotic compression fracture cases of thoracolumbar junction (group I) which were treated conservatively using TLSO brace were evaluated compared with 20 osteoporotic spine cases (group II), between August 2010 and March 2012. The mean age was 65.3, ranging from 57 to 71 years old. The average follow up period was 27.4, ranging from 17 to 35 months. The bone marrow density (BMD) was recorded at the initial assessment. The lumbar lordotic angles with compression ratios on the initial and the last follow-up plain lateral radiograph were measured, and the sagittal alignments of spine were evaluated.
RESULTS
In group I, the average compression ratios initially and at the last follow up were 23.5% and 33.7% respectively, and the average lumbar lordotic angles initially and at the last follow up were 30.8degrees and 22.6degrees respectively. In group II, the average lumbar lordotic angles initially and at the last follow up were 40.3degrees and 39.9degrees respectively. In group I, the compression ratio was significantly increased, and the lumbar lordotic angle was decreased at the final follow up. In group II, the difference of lumbar lordotic angles was not significant statistically.
CONCLUSIONS
In most, the osteoporotic compression fractures can be successfully managed conservatively. But, in some cases of thoracolumbar junction, the further collapse of vertebral body and the change of lumbar lordotic angle can be developed, and then sagittal alignment of spine can be disrupted.