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

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. Radiolog...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 48; no. 2; pp. 1401 - 1409
Autores principales: 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, Olbrich, Annett
Formato: research tables/charts Journal Article
Publicado: Springer Nature Apr2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2022
      vid: 48
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      pub: Springer Nature
      place: New York, New York
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        atl: Multicenter evaluation of therapeutic strategies of inpatients with osteoporotic vertebral fractures in Germany.
      aug:
        au:
          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
          Olbrich, Annett
        affil: Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Rathsberger Strasse 57, 91054, Erlangen, Germany
      sug:
        subj:
          Thoracic Vertebrae Injuries
          Lumbar Vertebrae Injuries
          Hospitalization
          Spinal Fractures Surgery
          Osteoporotic Fractures Surgery
          Orthopedic Surgery Methods
          Health Care Delivery Evaluation
          Human
          Inpatients
          Multicenter Studies
          Prospective Studies
          Trauma Centers
          Germany
          Surgical Patients
          Spine Radiography
          Spinal Fractures Physiopathology
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Spinal Fractures Classification
          Severity of Injury
          Disease Progression
          Odds Ratio
          Anticoagulants
          Dementia
          Scales
          Pain Measurement
          Treatment Duration
          Descriptive Statistics
          Fractures, Vertebral Compression
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: 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 L1 (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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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