Operative Behandlung von Verletzungen des thorakolumbalen Übergangs

Knop, C.; Blauth, M.; Bühren, V.; Hax, P.-M.; Kinzl, L.; Mutschler, Wolf; Pommer, Axel; Ulrich, C.; Wagner, Siegfried; Weckbach, A.; Wentzensen, Andreas; Wörsdörfer, O.

doi:10.1007/s001130050507

Cited by 118 publications

(31 citation statements)

References 34 publications

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“…5 Neurological injury complicates 20-36% of fractures at the thoracolumbar junction in different studies. [6][7][8] Conventional radiographs with anteroposterior and lateral radiographs are usually the first technique used to study patients suspected for VF. Radiographic evaluation should include spinal alignment, the presence of any rotation or translation, assessment of the kyphosis, loss of vertebral height and widened interpedicular or interspinous distance.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain

Marcia¹,

Saba²,

Marras³

et al. 2016

BJR

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Vertebral fracture (VF) is a common condition with .160,000 patients affected every year in North America and most of them with affected lumbar vertebrae. The management of VF is well known and defined by many protocols related to associated clinical neurological symptoms, especially in case of the presence or absence of myelopathy or radicular deficit. In this article, we will explore the percutaneous stabilization of the lumbar spine by showing the newest approaches for this condition.

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Section: Introductionmentioning

confidence: 99%

Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain

Marcia¹,

Saba²,

Marras³

et al. 2016

BJR

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“…Burst fractures are common thoracolumbar junction injuries [1]. Dorsal fixation of the thoracolumbar burst fractures is widely accepted as a treatment option [2,3].…”

Section: Introductionmentioning

confidence: 99%

Outcome after thoracoscopic ventral stabilisation of thoracic and lumbar spine fractures

Pfeifer¹,

Pishnamaz²,

Dombroski

et al. 2012

J Trauma Manage Outcomes

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Background and PurposeThoracoscopic-assisted ventral stabilisation for thoracolumbar fractures has been shown to be associated with decreased recovery time and less morbidity when compared with open procedures. However, there are a limited number of studies evaluating late clinical and radiological results after thoracoscopic spinal surgery.MethodsWe performed an analysis of the late outcomes of thoracolumbar fractures after minimally invasive thoracoscopic ventral instrumentation. Between August 2003 and December 2008, 70 patients with thoracolumbar fractures (T5-L2) underwent ventral thoracoscopic stabilisation. Tricortical bone grafts, anterior plating systems (MACS-System), and cage implants were used for stabilisation. Outcomes measured include radiologic images (superior inferior endplate angle), Visual Analogue Scale (VAS), VAS Spine Score, quality of life scores SF-36 and Oswestry Disability Index (ODI).ResultsForty seven patients (67%, 47 out of 70) were recruited for the follow up evaluation (2.2 ± 1.5 years). Lower VAS Spine scores were calculated in patients with intra- or postoperative complications (44.7 (± 16.7) vs. 65.8 (± 24.5), p=0.0447). There was no difference in outcome between patients treated with bone graft vs. cage implants. Loss of correction was observed in both bone graft and titanium cage groups.InterpretationThe present study demonstrates diminished long-term quality of life in patients treated with thoracoscopic ventral spine when compared with the outcome of german reference population. In contrast to the other patients, those patients without intra-operative or post-operative complications were associated with improved outcome. The stabilisation method (bone graft versus spinal cage) did not affect the long-term clinical or radiographic results in this series.

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“…The definition of the thoracolumbar junction varies in clinical studies between being T10 to L2 (Knop et al. 1999, Wood et al. 2003, Park et al.…”

Section: Discussionmentioning

confidence: 99%

Concomitant and previous osteoporotic vertebral fractures

2017

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Background and purposePatients with osteoporosis who present with an acute onset of back pain often have multiple fractures on plain radiographs. Differentiation of an acute osteoporotic vertebral fracture (AOVF) from previous fractures is difficult. The aim of this study was to investigate the incidence of concomitant AOVFs and previous OVFs in patients with symptomatic AOVFs, and to identify risk factors for concomitant AOVFs.Patients and methodsThis was a prospective epidemiological study based on the Registry of Pathological Osteoporotic Vertebral Fractures (REPAPORA) with 1,005 patients and 2,874 osteoporotic vertebral fractures, which has been running since February 1, 2006. Concomitant fractures are defined as at least 2 acute short-tau inversion recovery (STIR-) positive vertebral fractures that happen concomitantly. A previous fracture is a STIR-negative fracture at the time of initial diagnostics. Logistic regression was used to examine the influence of various variables on the incidence of concomitant fractures.ResultsMore than 99% of osteoporotic vertebral fractures occurred in the thoracic and lumbar spine. The incidence of concomitant fractures at the time of first patient contact was 26% and that of previous fractures was 60%. The odds ratio (OR) for concomitant fractures decreased with a higher number of previous fractures (OR =0.86; p = 0.03) and higher dual-energy X-ray absorptiometry T-score (OR =0.72; p = 0.003).InterpretationConcomitant and previous osteoporotic vertebral fractures are common. Risk factors for concomitant fractures are a low T-score and a low number of previous vertebral fractures in cases of osteoporotic vertebral fracture. An MRI scan of the the complete thoracic and lumbar spine with STIR sequence reduces the risk of under-diagnosis and under-treatment.

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Operative Behandlung von Verletzungen des thorakolumbalen Übergangs

Cited by 118 publications

References 34 publications

Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain

Percutaneous stabilization of lumbar spine: a literature review and new options in treating spine pain

Outcome after thoracoscopic ventral stabilisation of thoracic and lumbar spine fractures

Concomitant and previous osteoporotic vertebral fractures

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