Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

Schnake, Klaus John; Blattert, T. R.; Hahn, Patrick; Franck, Alexander; Hartmann, Frank; Ullrich, Bernhard; Verheyden, A. P.; Mörk, Sven; Zimmermann, Volker; Gonschorek, O.; Müller, Michael; Katscher, S.; Saman, Abdul; Pajenda, Gholam; Morrison, Robert S.; Schinkel, Christian; Piltz, Stefan; Partenheimer, A.; Müller, Christian; Gercek, Erol; Scherer, M. A.; Bouzraki, Nabila; Kandziora, Frank

doi:10.1177/2192568217717972

Cited by 151 publications

(130 citation statements)

References 12 publications

(13 reference statements)

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“…Fracture classification was done in accordance with the new AO spine classification [3], the OF-classification [4], and an OF score of at least 6 [5]. The indication for surgery was in accordance with the spine section of the German society for orthopaedics and trauma (DGOU) [5].…”

Section: Methodsmentioning

confidence: 99%

Which anatomic structures are responsible for the reduction loss after hybrid stabilization of osteoporotic fractures of the thoracolumbar spine?

Spiegl

Ahrberg²,

Anemüller³

et al. 2020

BMC Musculoskelet Disord

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Introduction: Hybrid stabilization is an accepted therapy strategy for unstable osteoporotic thoracolumbar fractures. However, a moderate reduction loss has been reported and it remains unclear which anatomic structure is responsible for the reduction loss. Methods: This retrospective study was performed at a level I trauma center. Patients aged 61 and older were stabilized using hybrid stabilization after suffering acute and unstable osteoporotic vertebral body fractures at the thoracolumbar spine. Posterior stabilization was done short-segmental and minimal invasive with cement-augmentation of all pedicle screws. The minimum follow-up has been 2 years. The outcome parameters were the reduction loss and the relative loss of height of both intervertebral discs adjacent to the fractured vertebral body, the fractured vertebral body and a reference disc (intervertebral disc superior of the stabilization) between the postoperative and latest lateral radiographs. Additionally, implant positioning and loosening was analyzed. Results: 29 mainly female (72%) patients (73.3 ± 6.0 years) were included. Fractures consisted of 26 incomplete burst fractures and 3 complete burst fractures of the thoracolumbar junction (Th11-L2: 86%) and the midlumbar spine. The mean follow-up time was 36 months (range: 24-58 months). The mean reduction loss was 7.7°(range: 1-25). The relative loss of heights of both intervertebral discs adjacent to the fractured vertebral body, the reference disc, and the central vertebral body were significant. Thereby, the relative loss of the superior disc height was significant higher compared to the reference disc. Additionally, only the relative loss of central vertebral body height and reduction loss correlated significantly. There were no signs of implant loosening in any patient. Conclusions: The mean reduction loss was moderate 3 years after hybrid stabilization of unstable osteoporotic vertebral fractures of the thoracolumbar spine. A significant loss of both adjacent disc heights and the central vertebral body was seen, with the highest loss in the superior adjacent disc significantly outranging the reference disc. The superior adjacent intervertebral disc and the central part of the fractured vertebral body seem to be responsible for the majority of reduction loss.

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Section: Methodsmentioning

confidence: 99%

Which anatomic structures are responsible for the reduction loss after hybrid stabilization of osteoporotic fractures of the thoracolumbar spine?

Spiegl

Ahrberg²,

Anemüller³

et al. 2020

BMC Musculoskelet Disord

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“…Die OF-Klassifikation wurde von der Arbeitsgruppe "Osteoporotische Frakturen" der Sektion Wirbelsäule der DGOU entwickelt [19]. Sie beinhaltet 5 Gruppen (▶ Abb.…”

Section: Of-klassifikation Und Of-scoreunclassified

“…▶ Abb. 3 Morphologische Einteilung der osteoporotischen Wirbelkörperfraktur nach der OF-Klassifikation (Arbeitsgruppe Osteoporotische Frakturen der Sektion Wirbelsäule der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie) [19].…”

Section: Rumpforthesenunclassified

Klassifikation und Therapieempfehlung der osteoporotischen Wirbelkörperfraktur

Zwingenberger¹,

Thomas²,

Schaser³

et al. 2019

Die Wirbelsäule

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“…Osteoporotic vertebral compression fractures(OVCFs) is a common fracture event with gradually higher morbidity and mortality as that increases in the elderly. An estimated 1.4 million of new fractures occurred every year worldwide [1][2]. OVCFs have been treated with conservative managements, such as bed rest, analgesics, braces while surgical treatment are percutaneous vertebroplasty(PV) or percutaneous kyphoplasty (PK) or segmental instrumentation.…”

Section: Introductionmentioning

confidence: 99%

The clinical efficacy of three application methods of local anesthesia in percutaneous vertebroplasty: A retrospective single-center cohort study

Liang

Zhong

Huang

et al. 2020

Preprint

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Background: Although various studies have described the methods of anaesthesia in percutaneous vertebroplasty(PV) in treating osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen.The study aims to investigate the efficacy of three application methods of local anesthesia in PV treating OVCFs.Methods：A total of 96 patients of OVCFs were reviewed and divided into three groups(A: lidocaine, B: ropivacaine, C: lidocaine+ropivacaine). The visual analog scale(VAS), blood pressure(BP), heart rate(HR), blood oxygen saturation(BOS), surgery time were recorded at the points of before puncture, puncture, cement injection, and after surgery.Results: The mean age of the patients was 74.13±7.02 years in group A, 70.47±5.50 years in group B, and 73.07±7.51 years respectively without significant difference. No significant differences were found in the sex, age, hospital stay, surgery time, blood loss, and cement volume. During the period of before surgery and 4-hour after surgery, the VAS in group C decreased significantly at the period of puncture, cement injection, immediately after surgery. Overall, the systolic BP, diastolic BP, HR, BOS during the different period among the groups, there were no significant differences except the HR in the period of the puncture in group C was slower than that in other groups and HR in the period of cement injection in the group A was faster than other two groups. A correlation was observed between the VAS and the period of cement injection(r=0.5358), after surgery(r=0.5775) in group C.Conclusion: In conclusion, the use of the lidocaine in combination with ropivacaine could relieve the effective intraoperative pain in PV treating OVCFs patients which is reliable and safe.

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Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU)

Cited by 151 publications

References 12 publications

Which anatomic structures are responsible for the reduction loss after hybrid stabilization of osteoporotic fractures of the thoracolumbar spine?

Which anatomic structures are responsible for the reduction loss after hybrid stabilization of osteoporotic fractures of the thoracolumbar spine?

Klassifikation und Therapieempfehlung der osteoporotischen Wirbelkörperfraktur

The clinical efficacy of three application methods of local anesthesia in percutaneous vertebroplasty: A retrospective single-center cohort study

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