# Correlation between spinopelvic sagittal balance and vertebral fractures in postmenopausal women

## TL;DR

This study explores how spine and pelvis alignment relates to vertebral fractures in postmenopausal women with osteoporosis.

## Contribution

The study identifies global tilt as a significant factor correlated with vertebral fractures in this population.

## Key findings

- Global tilt (GT) correlates significantly with fracture presence, increasing fracture risk by 2.1% per degree.
- Spinal deformity index (SDI) correlates with global sagittal balance measured by GT.
- Fractures are more prevalent in women with higher GT values.

## Abstract

To investigate the relationship between spinopelvic alignment and vertebral
fracture in postmenopausal women with osteoporosis.

This was a retrospective cross-sectional study including 93 women diagnosed
with osteopenia or osteoporosis by densitometry between June 2017 and March
2018. Using the software Surgimap to analyze lateral X-rays of the spine and
pelvis, we measured the following spinopelvic parameters: pelvic incidence
(PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical axis (SVA),
global tilt (GT), spinosacral angle (SSA), T1 pelvic angle (TPA), lumbar
lordosis (LL), and thoracic kyphosis (TK). The spinopelvic parameters were
assessed in relation to fracture occurrence by estimating prevalence ratios.
Two groups (patients with and without fractures) were compared on the basis
of their spinopelvic parameters. Vertebral fractures were graded by the
Genant classification, and the spinal deformity index (SDI) was calculated
as the sum of the grades. The SDI was found to correlate with spinopelvic
parameters. Intraobserver and interobserver reliability for the measurement
of the spinopelvic parameters was evaluated.

The GT correlated significantly with the presence of fractures; the incidence
of fracture was found to increase by 2.1% for every 1-degree increase in the
GT. The presence of fractures was not found to correlate significantly with
the SS, PT, PI, LL, TK, SVA, or SSA. The GT was significantly greater in the
group with fractures than in the group without fractures. The SDI correlated
significantly with global sagittal balance, as measured by the GT.

Fractures seem to be more prevalent among women with a higher GT. The SDI
appears to correlate well with global sagittal balance, as assessed by the
GT.