Introduction: Acromegaly is commonly complicated by arthropathy and skeletal fragility with high risk of vertebral fractures (VFs). Objective: This study aimed to assess whether VFs may be associated with sagittal spine deformities, arthropathy, impaired quality of life (QoL), pain and disability. Methods: Thirty-eight patients with acromegaly (median age 55 years, 20 males) and 38 matched-control subjects were evaluated by a low dose sagittal and coronal planes, X-ray imaging system (EOS®-2D/3D) for morphometric VFs, radiological signs of spine arthropathy and spine deformities (Cobb thoracic index ≥ 40°, pelvic incidence minus lumbar lordosis ≥ 10°, pelvic tilt > 20°, sagittal vertical axis ≥ 4 cm) determining sagittal spine imbalance. Acromegalic patients were also evaluated by questionnaires for QoL (Acromegaly QoL Questionnaire [AcroQoL] and Short Form-36 [SF36]), pain and disability (Western Ontario and Mc Master University [WOMAC]. Results: Acromegalic patients showed higher prevalence of thoracic hyperkyphosis (i.e., Cobb thoracic index ≥ 40°; p=0.04), pelvic tilt > 20° (p=0.02) than control subjects. VFs were found in 34.2% of acromegalic patients (p=0.003 vs. control subjects), in relationship with higher prevalence of hyperkyphosis (p=0.03), pelvic tilt > 20° (p=0.04), sagittal vertical axis ≥ 4 cm (p=0.03) and moderate/severe subchondral degeneration (p=0.01). Moreover, patients with VFs had lower AcroQoL general health (p=0.007) and SF36 general health (p=0.002) scores and higher WOMAC pain (p=0.003) and global (p=0.009) scores than patients who did not fracture. Conclusions: In acromegaly, VFs may be associated with spine deformities and sagittal imbalance, spine arthropathy, impaired QoL and disability.


中文翻译：

---

肢端肥大症与脊柱矢状面不平衡和生活质量相关的脊椎骨折：采用 EOS 2D/3D 技术的放射学研究。

简介：肢端肥大症通常并发关节病和骨骼脆弱，椎体骨折（VFs）的风险很高。目的：本研究旨在评估 VF 是否可能与矢状面脊柱畸形、关节病、生活质量受损 (QoL)、疼痛和残疾有关。方法：38 名肢端肥大症患者（中位年龄 55 岁，20 名男性）和 38 名匹配对照受试者通过低剂量矢状面和冠状面、X 射线成像系统 (EOS®-2D/3D) 进行形态测量 VFs 评估，脊柱关节病和脊柱畸形的放射学体征（Cobb 胸指数 ≥ 40°，骨盆倾角减去腰椎前凸 ≥ 10°，骨盆倾斜 > 20°，矢状垂直轴 ≥ 4 cm）确定矢状面脊柱不平衡。009) 得分高于没有骨折的患者。结论：在肢端肥大症中，VF 可能与脊柱畸形和矢状面失衡、脊柱关节病、生活质量受损和残疾有关。