BACKGROUND:Sagittal imbalance induced by vertebral osteoporotic fractures has not been paid enough attention in previous studies. OBJECTIVE:To assess the correlation of osteoporotic vertebral compression fracture and spinal sagittal imbalance. METHODS:Sixty patients with old osteoporotic vertebral compression fracture, who were treated in the Department of Spine Surgery, the Affiliated Hospital of Chengde Medical Colege from February 2013 to August 2015, were enroled in this study as the observation group. Sixty healthy old people from physical examination center were enroled as the control group. The whole-spine anteroposterior and lateral X-ray films were taken in both groups. The number and the location of fractured vertebrae were recorded. Sagittal parameters of both groups including thoracic kyphotic angle, lumbar lordotic angle, T1-spinopelvic inclination angle and the C7plumb line/sacro-femoral distance (PL/SFD) ratio were measured and compared among groups. The observation group was dividedinto three subgroups according to the number of fractured vertebrae,i.e., single-vertebrae fracture subgroup, double-vertebrae fracture subgroup and above triple-vertebrae fracture subgroup. The C7PL/SFD ratio of the three subgroups was compared. The correlation between the number of fractured vertebrae and the C7PL/SFD ratio was analyzed. RESULTS AND CONCLUSION:(1) The thoracic kyphotic angle of the observation group was bigger than that of the control group (P< 0.05). The lumbar lordotic angle of the observation group was smaler than that of the control group (P< 0.05). The absolute value of the T1-spinopelvic inclination angle of the observation group (-1.81±1.48)° was smaler than that of the control group (-3.35±1.22)° (P< 0.05). The C7PL/SFDratio of the observation group was significantly bigger than that of the control group (P< 0.05). (2) In the observation group, there were 4 cases of single-vertebrae fracture, 25 cases of double-vertebrae fracture and 31 cases of above triple-vertebrae fracture. Significant differences in the C7PL/SFD ratio were determined among subgroups (P< 0.05). The number of fractured vertebrae was positively correlated with the C7PL/SFD ratio; the correlation coefficient was 0.747. (3) Results indicated that osteoporotic vertebral compression fracture can change spinal local sagittal alignment. Multiple compression fractures of vertebrae can cause spinal sagittal imbalance. The gravity center of human body shifts forward. The number of fractured vertebrae was positively correlated with the range of shift forward.%背景：国内外研究对于椎体骨质疏松性骨折造成的矢状位失衡重视不够。 目的：评估骨质疏松性椎体压缩骨折与脊柱矢状位失衡的相关性。 方法：纳入2013年2月至2015年8月在承德医学院附属医院脊柱外科就诊的陈旧性骨质疏松性椎体压缩骨折患者60例，作为观察组；另外选择体检科同龄老年健康查体人群60例作为对照组。拍摄两组脊柱全长正侧位 X 射线片记录脊柱椎体骨折数目和位置，测量矢状位参数包括胸椎后凸角、腰椎前凸角、T1脊柱骨盆倾斜角、C7矢状位比值，进行组间比较。将观察组中椎体骨折数目按单个椎体、双个椎体、3个及以上椎体分为3个亚组，比较3个亚组间C7矢状位比值的差别，分析椎体骨折数目和C7矢状位比值之间的相关关系。 结果与结论：①观察组胸椎后凸角显著大于对照组，差异有显著性意义(P<0.05)；观察组腰椎前凸角显著小于对照组，差异有显著性意义(P<0.05)；观察组T1脊柱骨盆倾斜角为(-1.81±1.48)°，对照组为(-3.35±1.22)°，两组相比差异有显著性意义(P<0.05)；观察组C7矢状位比值显著大于对照组，差异有显著性意义(P<0.05)；②观察组中单椎骨折亚组患者4例，双椎骨折25例，3个及以上椎骨折31例，3个亚组间C7矢状位比值比较，差异有显著性意义(P <0.05)；而且骨折数目与C7矢状位比值呈正相关，相关系数为0.747；③结果提示，骨质疏松性椎体压缩骨折可以引起脊柱矢状位序列改变，随骨折椎体数目增多出现整体矢状位序列失衡，脊柱重心前移，骨折数目与重心前移呈正相关。
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