Difference in the Cobb Angle Between Standing and Supine Position as a Prognostic Factor After Vertebral Augmentation in Osteoporotic Vertebral Compression Fractures.
Difference in the Cobb Angle Between Standing and Supine Position as a Prognostic Factor After Vertebral Augmentation in Osteoporotic Vertebral Compression Fractures.
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DOI：
10.14245/ns.2143172.586
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发表时间：
2022-06
期刊：
影响因子：
3.2
通讯作者：
ryeong, Kim Deok
中科院分区：
文献类型：
--
作者：
Bae, In-Suk;Moon, Byung Gwan;Kang, Hee In;Kim, Jae Hoon;Jwa, Cheolsu;ryeong, Kim Deok
我们回顾性分析了接受椎体加固的骨质疏松性椎体压缩性骨折（OVCF）患者，比较了仰卧位和站立位的Cobb角变化以及临床结局。 我们回顾性地提取了接受椎体增强术的OVCF患者的数据。使用视觉模拟量表（VAS）评估背痛。治疗前评估仰卧位和站立位X线片，以确定Cobb角和压缩比。进行受试者工作特征曲线分析，以确定预测椎体增强术后良好结局的最佳临界值。 共纳入249例患者。我们观察到随着Cobb角和压缩比的增加，VAS评分的变化有统计学意义的增加（p < 0.001），多变量logistic回归分析显示Cobb角（比值比[OR]，1.27）和压缩比（OR，1.12）的差异是预测椎体增强术后短期良好结局的独立风险因素。此外，我们发现Cobb角的差异（OR，1.05）是预测椎体增强后中期有利结局的唯一因素。预测中期有利结局的Cobb角差异的最佳截止值为35.526°。 我们发现，当站立位和仰卧位之间的Cobb角差异约为35%或更大时，椎体加固后的中期临床结局更好。外科医生在决定对OVCF患者进行椎体增强时，应注意Cobb角的差异，这取决于体位。
We retrospectively analyzed patients with osteoporotic vertebral compression fracture (OVCF) undergoing vertebral augmentation to compare the Cobb angle changes in the supine and standing positions and the clinical outcomes. We retrospectively extracted the data of OVCF patients who underwent vertebral augmentation. Back pain was assessed using a visual analogue scale (VAS). Supine and standing radiographs were assessed before treatment to determine the Cobb angle and compression ratio. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff to predict favorable outcomes after vertebral augmentation. A total of 249 patients were included. We observed a statistically significant increase in the VAS score change with increasing Cobb angle and compression ratio (p < 0.001), and multivariate logistic regression analysis showed that a difference in the Cobb angle (odds ratio [OR], 1.27) and compression ratio (OR, 1.12) were the independent risk factors for predicting short-term favorable outcomes after vertebral augmentation. In addition, we found that the difference in the Cobb angle (OR, 1.05) was the only factor for predicting midterm favorable outcomes after vertebral augmentation. The optimal cutoff value of the difference in the Cobb angle for predicting midterm favorable outcomes was 35.526°. We found that the midterm clinical outcome after vertebral augmentation was better when there was a difference of approximately 35% or more in the Cobb angle between the standing and supine positions. Surgeons should pay attention to the difference in the Cobb angle depending on the posture when deciding to perform vertebral augmentation in patients with OVCFs.