Correlation between clinical outcomes and spinopelvic parameters in osteoporosis

Introduction : Little data is available on the relationship between sagittal spinopelvic parameters and health related quality of life (HRQOL) in osteoporotic patients. The aim of this study was to identify relationships between spinopelvic parameters and HRQOL in osteoporosis. Material and methods : The patient and control groups comprised 138 osteoporotic patients and 40 controls. All underwent anteroposterior and lateral radiography of the whole spine, including hip joints, and completed clinical questionnaires. The radiographic parameters examined were; sacral slope, pelvic tilt, pelvic incidence, thoracic kyphosis, lumbar lordosis, and sagittal vertical axis. Lumbar spinal bone mineral density (LSBMD) and femoral neck BMD (FNBMD) of the non-dominant proximal femur were measured. A Visual Analogue Scale (VAS: 0-10) was used to assess back pain, and the Oswestry disability index (ODI) questionnaire and the Scoliosis Research Society (SRS-22) questionnaire to evaluate QOL. Statistical analysis was performed to identify significant differences between the patient and control groups. In addition, correlations between radiological parameters and clinical questionnaires were sought. Results : Patients and controls were found to differ significantly in terms of sagittal vertical axis, sacral slope, pelvic tilt, lumbar lordosis, and thoracic kyphosis. However, no significant intergroup difference was observed for pelvic incidence (P > 0.05). Correlation analysis revealed significant relationships between radiographic parameters and clinical outcomes. Multiple regression analysis was performed to identify predictors of clinical outcome, and the results obtained revealed that sagittal vertical axis, sacral slope, and FNBMD significantly predicted VAS, ODI, and SRS22 scores and that LSBMD predicted SRS-22 scores. Conclusions : Osteoporotic patients and controls were found to be significantly different in terms of sagittal spinopelvic parameters. Correlation analysis revealed significant relationships between radiographic parameters and clinical outcome variables. In particular, sagittal vertical axis, sacral slope, and FNBMD significantly predicted clinical outcomes in osteoporotic patients.