Therapieempfehlungen zur Versorgung von Verletzungen der Brust- und Lendenwirbelsäule

Verheyden, A. P.; Hölzl, Alexander; Ekkerlein, Helmut; Gercek, Erol; Hauck, Stefan; Josten, Christoph; Kandziora, Frank; Katscher, S.; Knop, C.; Lehmann, Wolfgang; Meffert, Rainer H.; Müller, Christian; Partenheimer, A.; Schinkel, Christian; Schleicher, Philipp; Schnake, Klaus John; Scholz, Matti; Ulrich, C.

doi:10.1007/s00113-010-1934-1

Cited by 63 publications

(28 citation statements)

References 28 publications

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“…Hence, with relative frequencies being analyzed relative to the total number of participants, the sum of relative frequencies could exceed 100 %. Descriptive statistics and the Fisher exact test (significance level a = 0.05) were used to analyze any differences between the five world regions, and the influence of clinical experience (B10, [11][12][13][14][15][16][17][18][19][20] or [20 years). …”

Section: Discussionmentioning

confidence: 99%

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Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

et al. 2016

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Purpose To investigate whether wide variations are seen in the measurement techniques preferred by spine surgeons around the world to assess traumatic fracture kyphosis and vertebral body height loss (VBHL). Methods An online survey was conducted at two time points among an international community of spine trauma experts from all world regions. The first survey (TL-survey) focused on the thoracic, thoracolumbar and lumbar spine, the second survey (C-survey) on the subaxial cervical spine. Participants were asked to indicate which measurement technique(s) they used for measuring kyphosis and VBHL. Descriptive statistics, frequency analysis and the Fisher exact test were used to analyze the responses.Results Of the 279 invited experts, 107 (38.4 %) participated in the TL-survey, and 108 (38.7 %) in the C-survey. The Cobb angle was the most frequently used for all spine regions to assess kyphosis (55.6-75.7 %), followed by the wedge angle and adjacent endplates method. Concerning VBHL, the majority of the experts used the vertebral body compression ratio in all spine regions (51.4-54.6 %). The most frequently used combination for kyphosis was the Cobb and wedge angles. Considerable differences were observed between the world regions, while fewer differences were seen between surgeons with different degrees of experience. Conclusions This study identified worldwide variations in measurement techniques preferred by treating spine surgeons to assess fracture kyphosis and VBHL in spine trauma patients. These results establish the importance of standardizing assessment parameters in spine trauma care, and can be taken into account to further investigate these radiographic parameters.

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Section: Discussionmentioning

confidence: 99%

“…Increasing VBHL has the potential to contribute to and enhance this instability, which can result in changes in the treatment plan. In the thoracolumbar spine, various studies have shown a kyphotic angle of 15°-30°or VBHL of more than 50 % to be associated with instability [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

et al. 2016

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“…With significant thoracolumbar kyphosis [23–25], sagittal imbalance will develop. Restoration of the spinal and spinopelvic sagittal alignment is becoming increasingly valued as an important prognostic indicator of improved clinical outcomes following deformity surgery [5, 26–28]. Therefore, the objective of the current study was to investigate the clinical and radiographic mid- to long-term results of surgically treated thoracolumbar burst fractures in a homogenous sample of patients with T12 or L1 burst fractures who met strict inclusion criteria.…”

Section: Introductionmentioning

confidence: 99%

Impact of Sagittal Balance on Clinical Outcomes in Surgically Treated T12 and L1 Burst Fractures: Analysis of Long-Term Outcomes after Posterior-Only and Combined Posteroanterior Treatment

Mayer

Ortmaier

Koller

et al. 2017

BioMed Research International

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Objective. Long-term radiological and clinical outcome retrospective study of surgical treatment for T12 and L1 burst fractures in perspective of sagittal balance measures. Methods. Patients with age of 16–60 years, complete radiographs, early surgical treatment surgery, and follow-up (F/U) > 18 months were included and strict exclusion criteria applied. Regional and thoracolumbar kyphosis angles (RKA and TLA) were measured preoperatively and at final F/U, as were parameters of the spinopelvic sagittal alignment. Clinical outcomes were assessed using validated measures. Results. 36 patients with age mean age of 39 years and F/U of 69 months were included. 61% of patients were treated with bisegmental posterior instrumentation (POST-I) and 39% with combined posteroanterior instrumented fusion (PA-F). At F/U, several indicators for clinical outcomes showed a significant correlation with radiographic measures in the overall cohort with inferior clinical outcomes corresponding with increasing residual deformity and sagittal malalignment. Statistical analysis failed to reach level of significance for the differences between POST-I and PA-F group at final F/U. Only a strong trend towards better restoration of the thoracolumbar alignment was observed for the PA-F group in terms of the RKA and TLA. Conclusions. Results in a surgically treated cohort of T12 and L1 burst fracture patients indicate that superior clinical outcomes depend on restoration of sagittal alignment.

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“…Studien konnten bei verminderter Knochendichte eine höhere Stabilität von zementaugmentierten Schrauben nachweisen [47]. Bei jungen knochengesunden Patienten wird eine Zementaugmentation hingegen nicht empfohlen [43] (Tab. 3).…”

Section: Zementaugmentation Der Pedikelschraubenunclassified

Planung, Vorbereitung und Kontrolle bei traumatisch bedingten Eingriffen im Bereich der BWS und LWS

Adermann¹,

Schmidt²,

Josten³

2011

OP-JOURNAL

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EinleitungFrakturen der Brust-und Lendenwirbelsäule spielen im klinischen Alltag aufgrund ihrer Häufigkeit und aufgrund der Morbidität und Mortalität eine wichtige Rolle. Die Inzidenz von Wirbelkör-perfrakturen wird in Deutschland mit 50/100 000, das Auftreten von neurologischen Ausfällen mit 3/100 000 angegeben. Dabei entfallen 15-37 % auf den Lumbalbereich und 15-24 % auf den Thorakalbereich [45] Because of the rising incidence of fractures in the past few years, the surgical treatment of fractures of the thoracic and lumbar spine is gaining increasing importance. The treatment is complicated and associated with high personal and technical requirements. The currently valid therapeutic recommendations must be individually adapted to the patient, his/her biological age, bone quality, level of physical activity, and personal expectations. Both dorsal and ventral as well as combined dorsoventral approaches are available for surgical treatment. A modern management concept should encompass intraoperative navigation, thoroscopicassisted approaches to the ventral spine, minimally invasive percutaneous surgical approaches and the possibility for a simultaneous dorsoventral procedure. The present article presents a survey on the planning and preparation for operations in the region of injured thoracic and lumbar spines and intraoperative control techniques such as navigation and neuromonitoring.Planung, Vorbereitung und Kontrolle bei traumatisch bedingten Eingriffen im Bereich der BWS und LWS

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Therapieempfehlungen zur Versorgung von Verletzungen der Brust- und Lendenwirbelsäule

Cited by 63 publications

References 28 publications

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Impact of Sagittal Balance on Clinical Outcomes in Surgically Treated T12 and L1 Burst Fractures: Analysis of Long-Term Outcomes after Posterior-Only and Combined Posteroanterior Treatment

Planung, Vorbereitung und Kontrolle bei traumatisch bedingten Eingriffen im Bereich der BWS und LWS

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