1. Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Body Fractures With Deformation of Both Endplates With or Without Posterior Wall Involvement (OF 4): Short-Term Results from the Prospective EOFTT Multicenter Study.
- Author
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Spiegl, Ulrich J A; https://orcid.org/0000-0002-5179-4192, Schenk, Philipp, Schnake, Klaus John, Ullrich, Bernhard W; https://orcid.org/0000-0001-8748-1190, Osterhoff, Georg; https://orcid.org/0000-0001-5051-0998, Scheyerer, Max J; https://orcid.org/0000-0003-1392-3990, Schmeiser, Gregor, Bäumlein, Martin, Scherer, Michael A, Müller, Michael, Sprengel, Kai; https://orcid.org/0000-0001-5921-8272, Liepold, Katja, Schramm, Simon, Baron, H-Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alex, Zimmermann, Volker, Katscher, Sebastian, et al, Spiegl, Ulrich J A; https://orcid.org/0000-0002-5179-4192, Schenk, Philipp, Schnake, Klaus John, Ullrich, Bernhard W; https://orcid.org/0000-0001-8748-1190, Osterhoff, Georg; https://orcid.org/0000-0001-5051-0998, Scheyerer, Max J; https://orcid.org/0000-0003-1392-3990, Schmeiser, Gregor, Bäumlein, Martin, Scherer, Michael A, Müller, Michael, Sprengel, Kai; https://orcid.org/0000-0001-5921-8272, Liepold, Katja, Schramm, Simon, Baron, H-Christopher, Siekmann, Holger, Schwarz, Falko, Franck, Alex, Zimmermann, Volker, Katscher, Sebastian, and et al
- Abstract
STUDY DESIGN: Multicenter prospective cohort study. OBJECTIVE: To analyse therapeutical strategies applied to osteoporotic thoracolumbar OF 4 injuries, to assess related complications and clinical outcome. METHODS: A multicenter prospective cohort study (EOFTT) including 518 consecutive patients who were treated for an Osteoporotic vertebral compression fracture (OVCF). For the present study, only patients with OF 4 fractures were analysed. Outcome parameters were complications, Visual Analogue Scale, Oswestry Disability Questionnaire, Timed Up & Go test, EQ-5D 5L, and Barthel Index after a minimum follow-up of 6 weeks. RESULTS: A total of 152 (29%) patients presented with OF 4 fractures with a mean age of 76 years (range 41-97). The most common treatment was short-segment posterior stabilization (51%; hybrid stabilization in 36%). Mean follow up was 208 days (±131 days), mean ODI was 30 ± 21. Dorsoventral stabilized patients were younger compared to the other groups (P < .001) and had significant better TuG compared to hybrid stabilization (P = .049). The other clinical outcomes did not differ in the therapy strategies (VAS pain: P = 1.000, ODI: P > .602, Barthel: P > .252, EQ-5D 5L index value: P > .610, VAS-EQ-5D 5L: P = 1.000). The inpatient complication rate was 8% after conservative and 16% after surgical treatment. During follow-up period 14% of conservatively treated patients and 3% of surgical treated patients experienced neurological deficits. CONCLUSIONS: Conservative therapy of OF 4 injuries seems to be viable option in patients with only moderate symptoms. Hybrid stabilization was the dominant treatment strategy leading to promising clinical short-term results. Stand-alone cement augmentation seems to be a valid alternative in selected cases.
- Published
- 2023