Predictors of kyphotic deformity in osteoporotic vertebral compression fractures: a radiological study

To report the radiological predictors of kyphotic deformity in osteoporotic vertebral compression fractures (OVCF).

This is a retrospective study of 64 consecutive patients with OVCF. We studied the radiographic features in the immediate post-injury image of patients, who developed significant (more than 30°) segmental kyphotic deformity at final follow-up and compared them with those patients who did not.

Thirty-three (82.5%) out of 40 patients with fracture at thoracolumbar (TL) junction, 5 (33.3%) patients out of 15 with fracture at lumbar (L) spine and 7 (77.7%) patients out of 9 with fracture at thoracic (T) spine developed significant segmental kyphotic deformity. Forty-one (75.9%) [TL-33 (80.5%), L-4 (33.33%) and T-4 (80%)] out of 54 [TL-37 (68.51%), L-12 (22.23%) and T-5 (9.26%)] patients with superior endplate fracture developed significant segmental kyphotic deformity. Forty patients (86.9%) [TL-28 (70%), L-6 (15%) and T-6 (15%)] out of 46 [TL-32 (69.56%), L-8 (17.4%) and T-6 (13.04%)] with anterior cortical wall fracture developed significant segmental kyphotic deformity. Five patients (71.42%) [TL-2 (40%) and T-3 (60%)] out of 7 [TL-02 (28.58%), L-01 (14.28%), T-04 (57.14%)] with adjacent level fracture developed significant segmental kyphotic deformity. The average immediate post-injury kyphosis of 11° (5°-25°) increased to 29° (15°-50°) at final follow-up.

Progressive segmental kyphotic collapse following an OVCF seems unavoidable. Patients with TL junction and superior endplate fracture are probably at the highest risk for significant segmental kyphotic deformity.