, Volume 22, Issue 6, pp 601–606 | Cite as

The acromegalic spine: fractures, deformities and spinopelvic balance

  • 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 OliveiraEmail author



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


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.


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%.


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.


Acromegaly Spinal column Osteoporotic fractures Sagittal balance kyphosis 



No funding has been received for this project.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest for this project.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The project was approved by the institution's Research Ethics Committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Bruno de Azevedo Oliveira
    • 1
  • Bruna Araujo
    • 2
  • Tainá Mafalda dos Santos
    • 2
  • Bárbara Roberta Ongaratti
    • 1
  • Carolina Garcia Soares Leães Rech
    • 2
  • Nelson Pires Ferreira
    • 2
  • Júlia Fernanda Semmelmann Pereira-Lima
    • 1
    • 2
  • Miriam da Costa Oliveira
    • 1
    • 2
    Email author
  1. 1.Programa de Pós-Graduação Em PatologiaUniversidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)Porto AlegreBrasil
  2. 2.Centro de Neuroendocrinologia, Complexo Hospitalar Santa Casa, UFCSPAPorto AlegreBrasil

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