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Radiographic Outcomes of Conservative and Operative Treatment in Isolated L1 Fractures

Background and Objectives: The adequate therapy of thoracolumbar fractures in the elderly population is still controversially discussed. The aim of this study was to evaluate and compare the results of conservatively and surgically treated younger (≤60a) and elderly patients (>60a) with fractures...

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Autores principales: Schuller, Andrea, Payr, Stephan, Pichler, Lorenz, Sator, Thomas, Ploetzl, Anna, Chocholka, Britta, Tiefenboeck, Thomas M., Sarahrudi, Kambiz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141568/
https://www.ncbi.nlm.nih.gov/pubmed/37109653
http://dx.doi.org/10.3390/medicina59040695
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author Schuller, Andrea
Payr, Stephan
Pichler, Lorenz
Sator, Thomas
Ploetzl, Anna
Chocholka, Britta
Tiefenboeck, Thomas M.
Sarahrudi, Kambiz
author_facet Schuller, Andrea
Payr, Stephan
Pichler, Lorenz
Sator, Thomas
Ploetzl, Anna
Chocholka, Britta
Tiefenboeck, Thomas M.
Sarahrudi, Kambiz
author_sort Schuller, Andrea
collection PubMed
description Background and Objectives: The adequate therapy of thoracolumbar fractures in the elderly population is still controversially discussed. The aim of this study was to evaluate and compare the results of conservatively and surgically treated younger (≤60a) and elderly patients (>60a) with fractures of L1. Materials and Methods: Patients (231) with isolated L1 fractures were included and treated at the University Clinic of Orthopedics and Trauma Surgery, Division of Trauma Surgery, Medical University of Vienna, during the observation period of 2012–2018. Results: Conservative treatment led to a significant increase in the vertebral and bi-segmental kyphosis angle in both age groups (young vertebral: p = 0.007; young bi-segmental: p = 0.044; old vertebral: p = 0.0001; old bis-segmental: p = 0.0001). A significant reduction in the vertebral angle in both age groups was achieved after operative treatment (young: p = 0.003, old: p = 0.007). The bi-segmental angle did not significantly improve after surgery in both age groups (≤60a: p = 0.07; >60a: p = 1.0). Conclusions: The study shows that conservative treatment does not seem to be sufficient for a correction of radiological parameters in young and elderly patients. In contrast, operative treatment led to a significant improvement of the vertebral kyphosis angle, without changing the bi-segmental kyphosis angle. These results suggest a greater benefit from operative treatment in patients ≤ 60a than in older patients.
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spelling pubmed-101415682023-04-29 Radiographic Outcomes of Conservative and Operative Treatment in Isolated L1 Fractures Schuller, Andrea Payr, Stephan Pichler, Lorenz Sator, Thomas Ploetzl, Anna Chocholka, Britta Tiefenboeck, Thomas M. Sarahrudi, Kambiz Medicina (Kaunas) Article Background and Objectives: The adequate therapy of thoracolumbar fractures in the elderly population is still controversially discussed. The aim of this study was to evaluate and compare the results of conservatively and surgically treated younger (≤60a) and elderly patients (>60a) with fractures of L1. Materials and Methods: Patients (231) with isolated L1 fractures were included and treated at the University Clinic of Orthopedics and Trauma Surgery, Division of Trauma Surgery, Medical University of Vienna, during the observation period of 2012–2018. Results: Conservative treatment led to a significant increase in the vertebral and bi-segmental kyphosis angle in both age groups (young vertebral: p = 0.007; young bi-segmental: p = 0.044; old vertebral: p = 0.0001; old bis-segmental: p = 0.0001). A significant reduction in the vertebral angle in both age groups was achieved after operative treatment (young: p = 0.003, old: p = 0.007). The bi-segmental angle did not significantly improve after surgery in both age groups (≤60a: p = 0.07; >60a: p = 1.0). Conclusions: The study shows that conservative treatment does not seem to be sufficient for a correction of radiological parameters in young and elderly patients. In contrast, operative treatment led to a significant improvement of the vertebral kyphosis angle, without changing the bi-segmental kyphosis angle. These results suggest a greater benefit from operative treatment in patients ≤ 60a than in older patients. MDPI 2023-04-01 /pmc/articles/PMC10141568/ /pubmed/37109653 http://dx.doi.org/10.3390/medicina59040695 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schuller, Andrea
Payr, Stephan
Pichler, Lorenz
Sator, Thomas
Ploetzl, Anna
Chocholka, Britta
Tiefenboeck, Thomas M.
Sarahrudi, Kambiz
Radiographic Outcomes of Conservative and Operative Treatment in Isolated L1 Fractures
title Radiographic Outcomes of Conservative and Operative Treatment in Isolated L1 Fractures
title_full Radiographic Outcomes of Conservative and Operative Treatment in Isolated L1 Fractures
title_fullStr Radiographic Outcomes of Conservative and Operative Treatment in Isolated L1 Fractures
title_full_unstemmed Radiographic Outcomes of Conservative and Operative Treatment in Isolated L1 Fractures
title_short Radiographic Outcomes of Conservative and Operative Treatment in Isolated L1 Fractures
title_sort radiographic outcomes of conservative and operative treatment in isolated l1 fractures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141568/
https://www.ncbi.nlm.nih.gov/pubmed/37109653
http://dx.doi.org/10.3390/medicina59040695
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