Percutaneous vertebroplasty and balloon kyphoplasty are both safe and effective procedures in case of patients with osteoporotic vertebral compression fractures. The authors have already reported a new technique called lordoplasty using polymethylmethacrylate to manage vertebral osteoporotic compression fractures. The purpose and indication of lordoplasty do not differ from that of percutaneous vertebroplasty or balloon kyphoplasty. However, there are advantages of lordoplasty in terms of restoration of the wedge and kyphotic angle and cost-effectiveness compared with the other procedures mentioned above. For the advantages of lordoplasty, authors thereby introduce the detailed procedure of lordoplasty.

Purpose
Osteoporosis is an age-related systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone contents, with a consequent increase in bone fragility. In severe osteoporosis progressive collapse of multiple vertebrae is and unsolved problem. Medical treatment appears to be too slow to prevent the course. Recently, there are some reports on the results of the percutaneous vertebroplasty (VP) in treating the multi-level osteoporotic vertebral compression fractures (VCFs). we reviewed painful multi-level osteoporotic VCFs treated by percutaneous VP and assess the efficacy and safety of multiple percutaneous cement VP in the treatment of multi-level osteoporotic VCFs.
Materials and Methods
From January 2008 to August 2010, the clinical cases and radiographic records were reviewed retrospectively for 28 patients treated for the multi-level painful osteoporotic VCFs by percutaneous cement VP. Initially radiography and MRI of the spine were performed. Spine radiographs were repeated at post-operation, 1,3 months and final follow-up. The patient’s outcomes of demographic, clinical, radiologic and procedural data were analyzed and assessed using self-report and physiological measures. A t-test was used for means of VAS, anterior vertebral height and kyphotic angle. Statistical analysis was performed with the SPSS(Version 15.0.1, Chicago, Illinois). The p-values of < 0.001 were deemed significant.
Results
The back pain recorded using the VAS improved significantly in all cases, from 7.7±1.0(6-10), points preoperatively to 2.0±0.7(1-3) points postoperatively (p<0.001) and then 2.8±0.8(1-4) points at the follow-up (p<0.001). The anterior heights increased from 17.40±4.98 to 21.02±5.36 after VP procedures (p<0.001) and finally 19.49±5.28 (p<0.001). The kyphotic angle was 12.58º preoperatively and improved to 4.39º postoperatively, but kyphotic deformities became worse in 12.80º.
Conclusion
The vertebroplasty for patients with multiple osteoporotic vertebral compression fractures may improve pain and can be effective for preventing adjacent fractures, restoration of vertebral height and maintenance of sagittal alignment. Patients with multiple osteoporotic compression fractures have many comorbidity, the surgeon should be conscious to all procedure.

Purpose
Recently, there is concern for spinal sagittal alignment associated with back pain. Nowadays many women wear high heels or high-heeled shoes for their beauty. We study change of spinal sagittal alignment when women are wearing high heels.
Materials and Methods
We raised 15 female adult volunteers to accept our study. They do not have past history, operation history and especially back pain. We applied X-rays for anteroposterior and lateral whole spine radiography when women were bare foot (Group I). In addition, we applied each X-rays when women were wearing 5 cm high heels (Group II) and 12 cm high heels (Group III). We estimate the spinal sagittal alignment distinguishing pelvic index from spinal index. We use ANOVA test of SPSS v18.0 statistically.
Results
The average age of women was 29.3(23-41) years old, and mean BMI (Body Mass Index) was 18.7(16.2-24.5) kg/m 2 . When volunteers were bare foot, the average pelvic incidence (PI) was 49.3 degree, pelvic tilt (PT) was 10.8 degree, and sacral slope (SS) was 37.9 degree. The each average of lumbar lordosis (LL), thoracic kyphosis (TK), T12 slope, and sagittal vertical line on middle point of C7 (C7 SVA) and T12 (T12 SVA) was 55.5 degree, 28.5 degree, 19.3 degree, -1.2 cm, and -3.8 cm. When women were wearing 5 Cm high heels, the average was each 49.2 degree, 18.9 degree, 35.4 degree, 54.9 degree, 29.1 degree, 20.5 degree, -2.0 cm, -2.5 cm. When women were wearing 12 cm high heels, the average was each 49.9 degree, 18.2 degree, 31.2 degree, 52.6 degree, 30.8 degree, 22.8 degree, -4.1 Cm, -4.1 cm. Compared with each group, sacral slope (SS) and vertical line on middle point of C7 was statistically significant in group III (p<0.05). There was no statistically correlation between group I and group II.
Conclusion
Spinal sagittal alignment can be changed if adult women wear high heels excessively. For maintaining of normal spinal sagittal alignment, We conclude adult women wearing high heels for a long time pay attention to change of their spinal sagittal alignment.