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Lokales Wirbelsäulenprofil nach operativer Behandlung thorakolumbaler und lumbaler Frakturen: Einfluss von Repositionstechnik und Knochenqualität

BACKGROUND: The goal of surgery for spinal injuries is fracture reduction, fixation and stable healing in a physiological position. Several open and minimally invasive surgical techniques are available. OBJECTIVE: The extent of open reduction and the fixation potential achieved by the AOSpine (AT) a...

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Autores principales: Ullrich, Bernhard Wilhelm, Ottich, Merle, Lawson McLean, Aaron, Mendel, Thomas, Hofmann, Gunther Olaf, Schenk, Philipp
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Medizin 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940758/
https://www.ncbi.nlm.nih.gov/pubmed/34110429
http://dx.doi.org/10.1007/s00113-021-01013-7
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author Ullrich, Bernhard Wilhelm
Ottich, Merle
Lawson McLean, Aaron
Mendel, Thomas
Hofmann, Gunther Olaf
Schenk, Philipp
author_facet Ullrich, Bernhard Wilhelm
Ottich, Merle
Lawson McLean, Aaron
Mendel, Thomas
Hofmann, Gunther Olaf
Schenk, Philipp
author_sort Ullrich, Bernhard Wilhelm
collection PubMed
description BACKGROUND: The goal of surgery for spinal injuries is fracture reduction, fixation and stable healing in a physiological position. Several open and minimally invasive surgical techniques are available. OBJECTIVE: The extent of open reduction and the fixation potential achieved by the AOSpine (AT) and Kluger (KT) techniques were compared. The influence of fracture morphology, age, sex, and bone quality on fracture reduction and secure fixation was investigated. MATERIAL AND METHODS: In this monocentric retrospective cohort study data of patients with traumatic thoracolumbar and lumbar fractures treated by AT or KT were analyzed. The bisegmental kyphotic angle (bGDW) of each injured spinal segment was determined. Normal bGDW values were extrapolated from the literature. The change of bGDW over time was analyzed under consideration of the bone quality in Hounsfield units (HU), injury severity according to the AOSpine classification, gender and age of patients. RESULTS: A total of 151 data sets were evaluated. The AT and KT methods achieved a similar extent of reduction (AT 10 ± 6°, KT 11 ± 8°; p = 0.786). In follow-up a mean reduction loss of −5 ± 4° was seen. The technique had no influence on this (p = 0.998). The fracture morphology just managed to achieve a significant influence (p = 0.043). Low HU correlated significantly but weakly with lower extent of reduction (r = 0.241, p < 0.003) and greater reduction loss (r = 0.272, p < 0.001). In the age group 50–65 years 21% of men and 43% of women had bone quality of < 110 HU. Age and HU were significantly correlated (r = −0.701, p < 0.001). CONCLUSION: The AT and KT are equivalent in terms of reduction and secure fixation properties. The high proportion of male and female patients with HU < 110 in the age group under 65 years and the influence on reduction and secure fixation emphasize the need for preoperative bone densitometry.
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spelling pubmed-89407582022-04-07 Lokales Wirbelsäulenprofil nach operativer Behandlung thorakolumbaler und lumbaler Frakturen: Einfluss von Repositionstechnik und Knochenqualität Ullrich, Bernhard Wilhelm Ottich, Merle Lawson McLean, Aaron Mendel, Thomas Hofmann, Gunther Olaf Schenk, Philipp Unfallchirurg Originalien BACKGROUND: The goal of surgery for spinal injuries is fracture reduction, fixation and stable healing in a physiological position. Several open and minimally invasive surgical techniques are available. OBJECTIVE: The extent of open reduction and the fixation potential achieved by the AOSpine (AT) and Kluger (KT) techniques were compared. The influence of fracture morphology, age, sex, and bone quality on fracture reduction and secure fixation was investigated. MATERIAL AND METHODS: In this monocentric retrospective cohort study data of patients with traumatic thoracolumbar and lumbar fractures treated by AT or KT were analyzed. The bisegmental kyphotic angle (bGDW) of each injured spinal segment was determined. Normal bGDW values were extrapolated from the literature. The change of bGDW over time was analyzed under consideration of the bone quality in Hounsfield units (HU), injury severity according to the AOSpine classification, gender and age of patients. RESULTS: A total of 151 data sets were evaluated. The AT and KT methods achieved a similar extent of reduction (AT 10 ± 6°, KT 11 ± 8°; p = 0.786). In follow-up a mean reduction loss of −5 ± 4° was seen. The technique had no influence on this (p = 0.998). The fracture morphology just managed to achieve a significant influence (p = 0.043). Low HU correlated significantly but weakly with lower extent of reduction (r = 0.241, p < 0.003) and greater reduction loss (r = 0.272, p < 0.001). In the age group 50–65 years 21% of men and 43% of women had bone quality of < 110 HU. Age and HU were significantly correlated (r = −0.701, p < 0.001). CONCLUSION: The AT and KT are equivalent in terms of reduction and secure fixation properties. The high proportion of male and female patients with HU < 110 in the age group under 65 years and the influence on reduction and secure fixation emphasize the need for preoperative bone densitometry. Springer Medizin 2021-06-10 2022 /pmc/articles/PMC8940758/ /pubmed/34110429 http://dx.doi.org/10.1007/s00113-021-01013-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access Dieser Artikel wird unter der Creative Commons Namensnennung 4.0 International Lizenz veröffentlicht, welche die Nutzung, Vervielfältigung, Bearbeitung, Verbreitung und Wiedergabe in jeglichem Medium und Format erlaubt, sofern Sie den/die ursprünglichen Autor(en) und die Quelle ordnungsgemäß nennen, einen Link zur Creative Commons Lizenz beifügen und angeben, ob Änderungen vorgenommen wurden. Die in diesem Artikel enthaltenen Bilder und sonstiges Drittmaterial unterliegen ebenfalls der genannten Creative Commons Lizenz, sofern sich aus der Abbildungslegende nichts anderes ergibt. Sofern das betreffende Material nicht unter der genannten Creative Commons Lizenz steht und die betreffende Handlung nicht nach gesetzlichen Vorschriften erlaubt ist, ist für die oben aufgeführten Weiterverwendungen des Materials die Einwilligung des jeweiligen Rechteinhabers einzuholen. Weitere Details zur Lizenz entnehmen Sie bitte der Lizenzinformation auf http://creativecommons.org/licenses/by/4.0/deed.de (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Originalien
Ullrich, Bernhard Wilhelm
Ottich, Merle
Lawson McLean, Aaron
Mendel, Thomas
Hofmann, Gunther Olaf
Schenk, Philipp
Lokales Wirbelsäulenprofil nach operativer Behandlung thorakolumbaler und lumbaler Frakturen: Einfluss von Repositionstechnik und Knochenqualität
title Lokales Wirbelsäulenprofil nach operativer Behandlung thorakolumbaler und lumbaler Frakturen: Einfluss von Repositionstechnik und Knochenqualität
title_full Lokales Wirbelsäulenprofil nach operativer Behandlung thorakolumbaler und lumbaler Frakturen: Einfluss von Repositionstechnik und Knochenqualität
title_fullStr Lokales Wirbelsäulenprofil nach operativer Behandlung thorakolumbaler und lumbaler Frakturen: Einfluss von Repositionstechnik und Knochenqualität
title_full_unstemmed Lokales Wirbelsäulenprofil nach operativer Behandlung thorakolumbaler und lumbaler Frakturen: Einfluss von Repositionstechnik und Knochenqualität
title_short Lokales Wirbelsäulenprofil nach operativer Behandlung thorakolumbaler und lumbaler Frakturen: Einfluss von Repositionstechnik und Knochenqualität
title_sort lokales wirbelsäulenprofil nach operativer behandlung thorakolumbaler und lumbaler frakturen: einfluss von repositionstechnik und knochenqualität
topic Originalien
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8940758/
https://www.ncbi.nlm.nih.gov/pubmed/34110429
http://dx.doi.org/10.1007/s00113-021-01013-7
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