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25.09.2019

The acromegalic spine: fractures, deformities and spinopelvic balance

verfasst von: Bruno de Azevedo Oliveira, Bruna Araujo, Tainá Mafalda dos Santos, Bárbara Roberta Ongaratti, Carolina Garcia Soares Leães Rech, Nelson Pires Ferreira, Júlia Fernanda Semmelmann Pereira-Lima, Miriam da Costa Oliveira

Erschienen in: Pituitary | Ausgabe 6/2019

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Abstract

Introduction

Axial skeleton arthropathy and osteoporotic vertebral fractures are common findings in acromegalic patients and can result in severe spinal deformity.

Objective

To investigate the presence of spinal fractures and deformities, sagittal imbalances, and spinopelvic compensatory mechanisms in acromegalics.

Patients and methods

58 patients with acromegaly from a referral neuroendocrinology center were prospectively evaluated by panoramic spine radiographs to detect the presence of fractures and scoliosis, to measure thoracic kyphosis, lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sagittal vertical axis (SVA). Sagittal imbalance criteria were considered: thoracic kyphosis > 50°, PI-LL > 10°, PT > 20° and SVA > 5 cm. Their medical records were analyzed for clinical and laboratorial data.

Results

The prevalence of fractures was 13.8%, predominantly in the thoracic spine, with mild and anterior wedge compressions. Scoliosis was present in 34.5% of the cases, all with degenerative lumbar curve apex. Thoracic kyphosis > 50º occurred in 36.8% of patients, PI-LL > 10° in 48.3%, PT > 20° in 41.4% and SVA > 5 cm in 12.1%.

Conclusion

Increased number of vertebral fractures and high prevalence of spinal deformities related to sagittal imbalance were detected, indicating the importance of monitoring bone comorbidities in acromegaly, with radiological evaluation of the spine as part of the follow up.

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Titel: The acromegalic spine: fractures, deformities and spinopelvic balance
verfasst von: Bruno de Azevedo Oliveira
Bruna Araujo
Tainá Mafalda dos Santos
Bárbara Roberta Ongaratti
Carolina Garcia Soares Leães Rech
Nelson Pires Ferreira
Júlia Fernanda Semmelmann Pereira-Lima
Miriam da Costa Oliveira
Publikationsdatum: 25.09.2019
Verlag: Springer US
Erschienen in: Pituitary / Ausgabe 6/2019
Print ISSN: 1386-341X
Elektronische ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-019-00991-7

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Introduction

Objective

Patients and methods

Results

Conclusion

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