Dorsal instrumentation with and without vertebral body replacement in patients with thoracolumbar osteoporotic fractures shows comparable outcome measures.
360° instrumentation
Dorsal instrumentation
Osteoporosis
Osteoporotic fracture
Journal
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
07
03
2021
accepted:
19
10
2021
revised:
23
08
2021
pubmed:
7
11
2021
medline:
21
5
2022
entrez:
6
11
2021
Statut:
ppublish
Résumé
In the surgical treatment of osteoporotic spine fractures, there is no clear recommendation, which treatment is best for the individual patient with vertebra plana and/or neurological deficit requiring instrumentation. The aim of this study was to evaluate clinical and radiological outcomes after dorsal or 360° instrumentation of osteoporotic fractures of the thoracolumbar spine in a cohort of patients representing clinical reality. A total of 116 consecutive patients were operated on between 2008 and 2020. Inclusion criteria were osteoporotic fracture, thoracolumbar location, and dorsal instrumentation. In 79 cases, vertebral body replacement (VBR) was performed additionally. Patient outcomes including complications, EQ-5D at follow-up, and sagittal correction were analyzed. Medical and surgical complications occurred in 59.5% of patients with 360° instrumentation compared to 64.9% of patients with dorsal instrumentation only (p = 0.684). Dorsal instrumentation plus VBR resulted in a sagittal correction of 9.3 ± 7.4° (0.1-31.6°) compared to 6.0 ± 5.6° (0.2-22.8°) after dorsal instrumentation only, respectively (p = 0.0065). EQ-5D was completed by 79 patients after 4.00 ± 2.88 years (0.1-11.8 years) and was 0.56 ± 0.32 (- 0.21-1.00) for VBR compared to 0.56 ± 0.34 (- 0.08-1.00) without VBR after dorsal instrumentation (p = 0.994). 360° instrumentation represents a legitimate surgical technique with no additional morbidity even for the elderly and multimorbid osteoporotic population. Particularly, if sufficient long-term construct stability is in doubt or ventral stenosis is present, there is no need to abstain from additional ventral reinforcement and decompression.
Identifiants
pubmed: 34741219
doi: 10.1007/s00586-021-07044-3
pii: 10.1007/s00586-021-07044-3
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1138-1146Informations de copyright
© 2021. The Author(s).
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