Multicenter evaluation of therapeutic strategies of inpatients with osteoporotic vertebral fractures in Germany

Schnake, Klaus John; Bouzakri, Nabila; Hahn, Patrick; Franck, Alexander; Blattert, Thomas R.; Zimmermann, Volker; Gonschorek, Oliver; Ullrich, Bernhard; Kandziora, Frank; Müller, Michael; Katscher, Sebastian; Hartmann, Frank; Mörk, Sven; Verheyden, Akhil; Schinkel, Christian; Piltz, Stefan und Olbrich, Annett (2021): Multicenter evaluation of therapeutic strategies of inpatients with osteoporotic vertebral fractures in Germany. In: European Journal of Trauma and Emergency Surgery, Bd. 48, Nr. 2: S. 1401-1408

Abstract

Purpose The aim of this study was to assess therapeutic strategies of inpatients with osteoporotic thoracolumbar fractures (OTF) in Germany. Methods Prospective multi-center study including 16 German-speaking trauma centers over a period of 7 months. All inpatients with OTF were included. Radiological and clinical data on admission and treatment modalities were assessed. Results Seven hundred and seven (99.3%) out of 712 included patients (73.3% female) could be evaluated. Mean age was 75 years (30-103). 51.3% could not remember any traumatic incident. Fracture distribution was from T2 to L5 with Ll1(19%) most commonly affected. According to the Magerl classification type A1 (52.1%) and A3 (42.7%) were most common B and C type injuries (2.6%) and neurological deficits (3.1%) were rare. Previous progression of vertebral deformation was evident in 34.4% of patients and related to t score below - 3 (Odds ratio 1.9661). Patients presented with anticoagulation medication (15.4%), dementia (13%), and ASA score> 3 (12.4%) frequently. 82.3% of patients complained of pain >4 on VAS, 37% could not be mobilized despite pain medication according to grade II WHO pain ladder. 81.6% received operative treatment. Kyphoplasty (63.8%) and hybrid stabilization including kyphoplasty with (14.4%) or without screw augmentation (7.6%) were the techniques most frequently used. Invasiveness of treatment increased with degree of instability. Conclusions OTF are mostly type A compression fractures. Patients suffer from severe pain and immobilization frequently. Progression of deformity is correlated to t score below - 3. Treatment of inpatients is mainly surgical, with kyphoplasty followed by hybrid stabilization as commonly used techniques.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1863-9933
• Sprache: Englisch