scholarly journals Spinopelvic sagittal imbalance is risky for development of proximal instrumented fracture after posterior instrumentation.

2021 ◽  
Author(s):  
Jen-Chung Liao ◽  
Wen-Jer Chen
Keyword(s):  
Posterior Instrumentation ◽  
Control Group ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Study Group ◽  
Fracture Type ◽  
Mineral Density ◽  
Spinopelvic Parameters ◽  
T Score ◽  
Proximal Junctional Failure

Abstract Backgrounds: Postoperative fracture of the upper instrumented vertebrae (UIV) is thought to be as fracture type of proximal junctional failure (PJF), which usually needs revision surgery for salvage. The purpose of this study was to investigate the influences of spinopelvic parameters, such as the pelvic incidence (PI) angles, sacral slope (SS) angles, and pelvic tilt (PT), sagittal vertical axis (SVA), and proximal local kyphosis (PLK) angle on the development of fracture type of proximal junctional failure after posterior instrumentation. Methods This was a retrospective 1:3 matched case-control cohort study: 24 patients in the study group and 72 patients in the control group. The weighted Charlson Comorbidity Index (CCI) and bone mineral density (BMD) with T score were recorded. In addition to spinopelvic parameters, PI-LL and spinopelvic realignment score were calculated. Results More comorbidities (CCI, p = 0.002), poorer bone density (T score, p = 0.001) were noted in the study group. Before surgery, the study group had significantly lower LL (p = 0.046), SS (p = 0.043), and significantly higher PLK (p < 0.001), PT (p = 0.044) than the control group. Postoperatively, the study group had significantly higher PLK (p < 0.001 ) and lower LL (p = 0.031) than the control group; the degree of PI-LL ( p = 0.007) remained significantly higher in the study group. Both preoperative (p = 0.026) and postoperative (p = 0.045) spinopelvic realignment scores was worse in the study goup. Conclusions Preoperative and postoperative lower LL/spinopelvic realignment score, and higher PLK/PI-LL were significantly associated with instrumented fracture at upper instrumented vertebrae. An appropriate LL and a lower PLK should be obtained at surgery to prevent the development of instrumented fracture.

scholarly journals Increasing pelvic incidence is associated with more global sagittal imbalance in ankylosing spondylitis with thoracolumbar kyphosis

2019 ◽  
Author(s):  
Diyu Song ◽  
Guoquan Zheng ◽  
Tianhao Wang ◽  
Dengbin Qi ◽  
Yan Wang
Keyword(s):  
Ankylosing Spondylitis ◽  
Pelvic Incidence ◽  
Vertical Axis ◽  
Control Group ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Thoracolumbar Kyphosis ◽  
Spinopelvic Parameters ◽  
Sagittal Vertical Axis ◽  
The Relationship

Abstract Background: Ankylosing spondylitis (AS) patients with kyphosis have an abnormal spinopelvic alignment and pelvic morphology. Most of them focus on the relationship of pelvic tilt (PT) or sacral slope (SS) and deformity, and relatively few studies have addressed the relationship between pelvic incidence (PI) and kyphosis in AS patients. The purpose of this study is to analyze the correlation between pelvic incidence (PI) and the spinopelvic parameters describing local deformity or global sagittal balance in AS patients with thoracolumbar kyphosis. Methods: A total of 94 patients with AS (91 males and 3 females) and 30 controls were reviewed. Sagittal spinopelvic parameters, including PI, PT, SS, thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis(LL), sagittal vertical axis(SVA), T1 pelvic angle(TPA), spinosacral angle(SSA) and spinopelvic angle(SPA) were measured. Statistical analysis was performed to identify the correlation of PI with other parameters. Results: Compared with the control group, the AS patients had significantly higher PI(47.4˚ vs. 43.2˚, P<0.001). PI in AS patients was found to be significantly positively correlated with TPA(r=0.533, R 2 =0.284, P<0.001), and negatively correlated with SPA(r=-0.504, R 2 =0.254, P<0.001). However, no correlations were found between PI and SVA, SSA, TK, TLK or LL in AS patients. Conclusion: The value of PI in AS patients with kyphosis was significantly higher than that of controls. Correlation analysis revealed that increasing PI was significantly correlated with more global sagittal imbalance, not with the local deformity in AS patients with thoracolumbar kyphosis.

scholarly journals Increasing pelvic incidence is associated with more global sagittal imbalance in ankylosing spondylitis with thoracolumbar kyphosis

2019 ◽  
Author(s):  
Diyu Song ◽  
Guoquan Zheng ◽  
Tianhao Wang ◽  
Dengbin Qi ◽  
Yan Wang
Keyword(s):  
Ankylosing Spondylitis ◽  
Sagittal Balance ◽  
Pelvic Incidence ◽  
Pearson Correlation ◽  
Control Group ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Thoracolumbar Kyphosis ◽  
Spinopelvic Parameters ◽  
The Relationship

Abstract Background: Ankylosing spondylitis (AS) patients with kyphosis have an abnormal spinopelvic alignment and pelvic morphology. Most studies focus on the relationship of pelvic tilt (PT) or sacral slope (SS) and deformity, and relatively few studies have addressed the relationship between pelvic incidence (PI) and kyphosis in AS patients. The purpose of this study is to analyze the correlation between pelvic incidence (PI) and the spinopelvic parameters describing local deformity or global sagittal balance in AS patients with thoracolumbar kyphosis. Methods: A total of 94 patients with AS (91 males and 3 females) and 30 controls were reviewed. Sagittal spinopelvic parameters, including PI, PT, SS, thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis(LL), sagittal vertical axis(SVA), the first thoracic vertebra pelvic angle(TPA), spinosacral angle(SSA) and spinopelvic angle(SPA) were measured. Pearson correlation (r) and unary linear regression model were used to analysis the relationship between PI and other spinopelvic parameters. Results: Compared with the control group, the AS patients had significantly higher PI(47.4˚ vs. 43.2˚, P<0.001). PI in AS patients was found to be significantly positively correlated with TPA(r=0.533, R2=0.284, P<0.001), and negatively correlated with SPA(r=-0.504, R2=0.254, P<0.001). However, no correlations were found between PI and SVA, SSA, TK, TLK or LL in AS patients. Conclusion: This study revealed that increasing PI was significantly correlated with more global sagittal imbalance, not with the local deformity in AS patients with thoracolumbar kyphosis. Key Words: ankylosing spondylitis, pelvic incidence, sagittal spinopelvic parameters, global sagittal balance

scholarly journals The effects of extreme low frequency pulsed electromagnetic field on bone mineral density and incidence of fractures in patients with end - stage renal disease on dialysis - three year follow up study

2018 ◽  
Vol 75 (3) ◽  
pp. 273-280
Author(s):  
Aleksandra Rakocevic-Hrnjak ◽  
Miljanka Vuksanovic ◽  
Nada Dimkovic ◽  
Aleksandar Djurovic ◽  
Natasa Petronijevic ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Low Frequency ◽  
Control Group ◽  
Study Group ◽  
Z Score ◽  
Pulsed Electromagnetic Field ◽  
Mineral Density ◽  
T Score ◽  
Pulsed Electromagnetic ◽  
End Stage

Background/Aim. A variety of physical therapy options has been developed for the treatment of musculoskeletal disorders including those characterized with low bone mineral density (BMD). Extreme low frequency pulsed electromagnetic field (ELF-PEMF) can accelerate bone formation. Patients with end stage of renal disease (ESRD) are predisposed to high incidence of fractures due to bone disorder with multifactorial pathogenesis. Vitamin D, calcium supplements, antiresorptive and anabolic drugs in those patients have changed pharmacodynamics and pharmacokinetics and have minimal or limited effects. The aim of this study was to assess the effectiveness of long-term ELF-PEMF therapy applied in concordance with physical exercise on bone mass, incidence of new bone fractures and parathyroid hormone concentrations in ESRD patients on dialysis. Methods. In this 3-year prospective clinical trial, 151 patients with ESRD on dialysis program were subjected to treatment with ELF-PEMF (18 Hz, 2 mT) applied during 40 min after 10 consecutive dialysis procedures, 4 times through one year (120 treatments in total during three years) together with kinesitherapy (study group) or only with kinesitherapy (control group) on the voluntary basis. Results. Total of 124 patients have completed the study. In the study group (n = 54), regardless of sex, significant improvements of BMD, T-score and Z-score on both lumbar spine and femoral neck were achieved after 3-year treatment with ELF-PEMF. In the control group (n = 70), significant decreases of BMD, T-score and Z-score as well as the higher incidence of new bone fractures were recorded. Conclusion. ELF-PEMF could be a convenient and safe non-pharmacological therapeutic strategy for fracture prevention in nephrology practices.

scholarly journals Increasing pelvic incidence is associated with more global sagittal imbalance in ankylosing spondylitis with thoracolumbar kyphosis: an observational retrospective study of 94 cases

2020 ◽  
Author(s):  
Diyu Song ◽  
Guoquan Zheng ◽  
Tianhao Wang ◽  
Dengbin Qi ◽  
Yan Wang
Keyword(s):  
Ankylosing Spondylitis ◽  
Pelvic Incidence ◽  
Pearson Correlation ◽  
Control Group ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Thoracolumbar Kyphosis ◽  
Spinopelvic Parameters ◽  
Sagittal Vertical Axis ◽  
The Relationship

Abstract Background: Ankylosing spondylitis (AS) patients with kyphosis have an abnormal spinopelvic alignment and pelvic morphology. Most studies focus on the relationship of pelvic tilt (PT) or sacral slope (SS) and deformity, and relatively few studies have addressed the relationship between pelvic incidence (PI) and kyphosis in AS patients. The purpose of this study is to analyze the correlation between pelvic incidence (PI) and the spinopelvic parameters describing local deformity or global sagittal balance in AS patients with thoracolumbar kyphosis.Methods: A total of 94 patients with AS (91 males and 3 females) and 30 controls (27 males and 3 females) were reviewed. The mean age was 36.8 years in AS patients and 34.4 years in controls. Gender ratios and mean age were similar in both group. Sagittal spinopelvic parameters, including PI, PT, SS, thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis(LL), sagittal vertical axis(SVA), the first thoracic vertebra pelvic angle(TPA), spinosacral angle(SSA) and spinopelvic angle(SPA) were measured. The same spine surgeons measured all the parameters of the AS and control group. All the sagittal spinopelvic parameters were compared between the groups. The relationship between PI and other spinopelvic parameters was analyzed with Pearson correlation (r) and unary linear regression model.Results: All the sagittal parameters were found to be significantly different between AS patients and controls. Compared with the control group, the AS patients had significantly higher PI(47.4˚ vs. 43.2˚, P<0.001). Correlation analysis revealed that PI in AS patients was significantly positively correlated with TPA(r=0.533, R2=0.284, P<0.001), and negatively correlated with SPA(r=-0.504, R2=0.254, P<0.001). However, no correlations were found between PI and SVA, SSA, TK, TLK or LL in AS patients.Conclusion: This study revealed that increasing PI was significantly correlated with more global sagittal imbalance, not with the local deformity in AS patients with thoracolumbar kyphosis.

scholarly journals Pemberian Kalium Buah Pisang Lampung terhadap Densitas Mineral Tulang pada Lansia

2019 ◽  
Vol 5 (1) ◽  
pp. 30
Author(s):  
Edy Waliyo ◽  
Nopriantini Nopriantini ◽  
Shelly Festilia Agusanty
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Random Sampling ◽  
The Elderly ◽  
Control Group ◽  
Mineral Density ◽  
Control Group Design ◽  
Separate Sample ◽  
Group Design ◽  
T Score

Abstract: Effect of Lampung Banana Potassium on Bone Mineral Density in the Elderly. This study aims to determine the effect of banana lampung on bone mineral density in the elderly in the Social Welfare Tresna Werdha and Werdha Graha Kasih Father’s home). This research is a research with experimental design with the separate sample pretest posttest control group design. The research was carried out in the Tresna Werdha Social Institution and the Werdha Graha Kasih Father’s house, from May to July 2017. The sampling technique was taken by random sampling The result of potassium feeding on 150 grams of banana per day for 30 days by increasing BMD T-score of 0.17 while in control group (without banana lampung) BMD T-score decreased by - 0.32. After intervention in both groups showed a difference of BMD T-score of 0.49. Abstrak: Pemberian Kalium Buah Pisang Lampung terhadap Densitas Mineral Tulang pada Lansia. Penelitian ini bertujuan untuk mengetahui mengetahui pengaruh pemberian buah pisang lampung terhadap bone mineral density pada lansia di wilayah Panti Sosial Tresna Werdha dan panti Werdha Graha Kasih Bapa). Penelitian yang dilakukan ini adalah penelitian dengan desain eksperimen dengan rancangan the separate sample pretest posttest control group design. Penelitian dilaksanakan di wilayah Panti Sosial Tresna Werdha dan panti Werdha Graha Kasih Bapa), mulai bulan Mei s/d Juli 2017. Teknik sampling diambil dengan cara random sampling Hasil pemberian kalium pada buah pisang lampung sebanyak 150 gr setiap hari selama 30 hari dengan dapat meningkatkan BMD T-score sebesar 0,17 sedangkan pada kelompok control (tanpa pemberian buah pisang lampung) BMD T-score menurun sebesar - 0,32. Setelah intervensi pada ke dua kelompok menunjukkan adanya perbedaan BMD T-score sebesar 0,49.

scholarly journals P707 Anti-TNFα therapy has no effect on bone mineral density in younger patients with inflammatory bowel disease: A single-centre observational study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S572-S572
Author(s):  
R Filip ◽  
S Jarmakiewicz - Czaja ◽  
D Piątek ◽  
J Sztembis ◽  
A Pękala ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Mean Value ◽  
Study Group ◽  
Mineral Density ◽  
Left Femur ◽  
Entire Study ◽  
Treatment Groups ◽  
T Score ◽  
Active Inflammation

Abstract Background Active inflammation negatively affects bone mineral density. Biological treatment, among others silences the excessive reaction of the immune system, which can also reduce the risk of osteoporosis. The aim of the study is to determine whether bone mineral density is higher in patients with biological therapy. Methods In total, 112 patients over 18 years of age with CD (Crohn’s Disease) or UC (Ulcerative colitis) were included in the study. The mean value age was 35 years. Patients who had received anti-TNFα therapy (biosimilar infliximab CT-P13 or adalimumab), and who underwent densitometric evaluation after two year treatment, were selected. Those who had never received anti-TNFα therapy were selected as controls. Information regarding age, sex, weight, duration of CD, use of glucocorticoids and bisphosphonates, and signs of disease activity at the time of densitometric measurement were collected. Bone mineral density was measured by dual-energy X-ray absorptiometry (DEXA) within femoral neck and lumbar spine. Results are reported as g/cm2 and presented either as Z-score or as a T-score. Results The study group has characterised a mean value BMI (Body Mass Index)—24. The group of patients with anti-TNFαα therapy showed an average T-score left femur −0.7744 (CD) and −0.4382 (UC), but without anti-TNFα therapy −0.6636 (CD) and −0.2208 (UC). The entire study group showed a mean value t-score left femur of −0.54286. There were no significant statistical differences between the examined groups and the effect of anti-TNFα therapy on BMI, T-score left femur, T-score L2–L4 Conclusion The results of the preliminary study assessing the effect of anti-TNFα therapy on bone mineral density among the two treatment groups (CD and UC) do not indicate significant differences after the introduction of such therapy

scholarly journals Can Melatonin Improve the Osteopenia of Perimenopausal and Postmenopausal Women? A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Tingting Bao ◽  
Liuting Zeng ◽  
Kailin Yang ◽  
Yuehua Li ◽  
Fengying Ren ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Meta Analysis ◽  
Analysis Data ◽  
Nutritional Supplement ◽  
Current Evidence ◽  
Control Group ◽  
Mineral Density ◽  
T Score ◽  
Registration Number ◽  
Substantial Heterogeneity

Objective. To assess the effectiveness and safety of melatonin for perimenopausal and postmenopausal women with osteopenia. Methods. In this meta-analysis, data from randomized controlled trials were obtained to assess the effects of melatonin versus placebo or western medicine in perimenopausal and postmenopausal women with osteopenia. The study’s registration number is CRD42018086238. The primary outcomes included bone mineral density (BMD) and T-score. Result. From 551 articles retrieved, three trials involving 121 patients were included. Due to the high-to-substantial heterogeneity (BMD: I2=96.9%, P=0.000; T-score: I2=74.9%, and P=0.019), the statistical analysis of BMD and T-score was abandoned. A systematic review was undergone for the two outcomes. Compared with the control group, melatonin may increase osteocalcin (WMD 4.97; 95% CI 3.14, 6.79; P<0.00001). Conclusion. Based on current evidence, melatonin might be used as a safe nutritional supplement to improve bone density in perimenopausal and postmenopausal women, but its efficacy needs to be further affirmed.

Implications of Spinopelvic Alignment for the Spine Surgeon

Neurosurgery ◽  
2011 ◽  
Vol 70 (3) ◽  
pp. 707-721 ◽  
Author(s):  
Vivek A. Mehta ◽  
Anubhav Amin ◽  
Ibrahim Omeis ◽  
Ziya L. Gokaslan ◽  
Oren N. Gottfried
Keyword(s):  
Sagittal Balance ◽  
Lumbar Lordosis ◽  
Pelvic Incidence ◽  
Degenerative Spondylolisthesis ◽  
Disease Process ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Spinopelvic Parameters ◽  
Spinopelvic Alignment ◽  
Spinopelvic Balance

Abstract The relation of the pelvis to the spine has previously been overlooked as a contributor to sagittal balance. However, it is now recognized that spinopelvic alignment is important to maintain an energy-efficient posture in normal and disease states. The pelvis is characterized by an important anatomic landmark, the pelvic incidence (PI). The PI does not change after adolescence, and it directly influences pelvic alignment, including the parameters of pelvic tilt (PT) and sacral slope (SS) (PI = PT 1 SS), overall sagittal spinal balance, and lumbar lordosis. In the setting of an elevated PI, the spineadapts with increased lumbar lordosis. To prevent or limit sagittal imbalance, the spine may also compensate with increased PT or pelvic retroversion to attempt to maintain anupright posture. Abnormal spinopelvic parameters contribute to multiple spinal conditions including isthmic spondylolysis, degenerative spondylolisthesis, deformity, and impact outcome after spinal fusion. Sagittal balance, pelvic incidence, and all spinopelvic parameters are easily and reliably measured on standing, full-spine (lateral) radiographs, and it is essential to accurately assess and measure these sagittal values to understand their potential role in the disease process, and to promote spinopelvic balance at surgery. In this article, we provide a comprehensive review of the literature regarding the implications of abnormal spinopelvic parameters and discuss surgical strategies for correction of sagittal balance. Additionally, the authors rate and critique the quality of the literature cited in a systematic review approach to give the reader an estimate of the veracity of the conclusions reached from these reports.

Implications of Spinopelvic Alignment for the Spine Surgeon

Neurosurgery ◽  
2011 ◽  
Vol 76 (suppl_1) ◽  
pp. S42-S56 ◽  
Author(s):  
Vivek A. Mehta ◽  
Anubhav Amin ◽  
Ibrahim Omeis ◽  
Ziya L. Gokaslan ◽  
Oren N. Gottfried
Keyword(s):  
Sagittal Balance ◽  
Lumbar Lordosis ◽  
Pelvic Incidence ◽  
Degenerative Spondylolisthesis ◽  
Disease Process ◽  
Sacral Slope ◽  
Sagittal Imbalance ◽  
Spinopelvic Parameters ◽  
Spinopelvic Alignment ◽  
Spinopelvic Balance

Abstract The relation of the pelvis to the spine has previously been overlooked as a contributor to sagittal balance. However, it is now recognized that spinopelvic alignment is important to maintain an energy-efficient posture in normal and disease states. The pelvis is characterized by an important anatomic landmark, the pelvic incidence (PI). The PI does not change after adolescence, and it directly influences pelvic alignment, including the parameters of pelvic tilt (PT) and sacral slope (SS) (PI = PT 1 SS), overall sagittal spinal balance, and lumbar lordosis. In the setting of an elevated PI, the spineadapts with increased lumbar lordosis. To prevent or limit sagittal imbalance, the spine may also compensate with increased PT or pelvic retroversion to attempt to maintain anupright posture. Abnormal spinopelvic parameters contribute to multiple spinal conditions including isthmic spondylolysis, degenerative spondylolisthesis, deformity, and impact outcome after spinal fusion. Sagittal balance, pelvic incidence, and all spinopelvic parameters are easily and reliably measured on standing, full-spine (lateral) radiographs, and it is essential to accurately assess and measure these sagittal values to understand their potential role in the disease process, and to promote spinopelvic balance at surgery. In this article, we provide a comprehensive review of the literature regarding the implications of abnormal spinopelvic parameters and discuss surgical strategies for correction of sagittal balance. Additionally, the authors rate and critique the quality of the literature cited in a systematic review approach to give the reader an estimate of the veracity of the conclusions reached from these reports.

Anti-tumor Necrosis Factor Therapy Increased Spine and Femoral Neck Bone Mineral Density of Patients with Active Ankylosing Spondylitis with Low Bone Mineral Density

2015 ◽  
Vol 42 (8) ◽  
pp. 1413-1417 ◽  
Author(s):  
Haibo Li ◽  
Qiuxia Li ◽  
Xi Chen ◽  
Chen Ji ◽  
Jieruo Gu
Keyword(s):  
Bone Mineral Density ◽  
Ankylosing Spondylitis ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Tumor Necrosis ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Mineral Density ◽  
Necrosis Factor

Objective.To evaluate the effect of anti-tumor necrosis factor (TNF) therapy on bone mineral density (BMD) in patients with active ankylosing spondylitis (AS) with low BMD.Methods.Eighty-nine patients with active AS with low BMD were randomly divided into either a study group or a control group. The study group received etanercept (50 mg/week) or adalimumab (40 mg/2 week) subcutaneously for 1 year. BMD of lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry, and bone turnover markers serum C telopeptide of type-I collagen (sCTX) and serum procollagen type-I N propeptide (PINP) were detected by ELISA at baseline and at end of study.Results.After 1 year, compared with baseline, there was a significant increase in spine and femoral neck BMD by a mean ± SD of 14.9% ± 15.6% (p < 0.0001) and 4.7% ± 7.9% (p < 0.0001) in the study group. In the control group, there was a significant decrease in spine and femoral neck BMD by a mean ± SD of −8.6% ± 9.7% (p < 0.0001) and −9.8% ± 11.5% (p < 0.0001). Compared with baseline, sCTX was significantly decreased in the study group (−40% at 1 yr, p < 0.0001), but bone-specific alkaline phosphatase and PINP increased (45.6%, p < 0.0001 and 30.8%, p < 0.0001, respectively).Conclusion.In patients with active AS with low BMD, the spine and femoral neck BMD increased after anti-TNF therapy for 1 year, and it was accompanied by a significant decrease in bone resorption markers and an increase in bone formation markers.

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