Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures
Abstract Background The purpose of this retrospective cohort study was to compare treatment strategies of two level-one trauma centers regarding clinical and radiological outcomes focusing on non-osteoporotic AOSpine type A3 fractures of the thoracolumbar spine at levels T11 to L2. Methods Eighty-se...
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| Format: | Article |
| Language: | English |
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BMC
2020-02-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-020-3099-6 |
| _version_ | 1819060615398817792 |
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| author | Christoph J. Erichsen Christoph-Eckhard Heyde Christoph Josten Oliver Gonschorek Stephanie Panzer Christian von Rüden Ulrich J. Spiegl |
| author_facet | Christoph J. Erichsen Christoph-Eckhard Heyde Christoph Josten Oliver Gonschorek Stephanie Panzer Christian von Rüden Ulrich J. Spiegl |
| author_sort | Christoph J. Erichsen |
| collection | DOAJ |
| description | Abstract Background The purpose of this retrospective cohort study was to compare treatment strategies of two level-one trauma centers regarding clinical and radiological outcomes focusing on non-osteoporotic AOSpine type A3 fractures of the thoracolumbar spine at levels T11 to L2. Methods Eighty-seven patients between 18 and 65 years of age that were treated operatively in either of two trauma centers were included. One treatment strategy includes open posterior stabilization whereas the other uses percutaneous posterior stabilization. Both included additional anterior fusion if necessary. Demographic data, McCormack classification, duration of surgery, hospital stay and further parameters were assessed. Owestry Disability Index (ODI), Visual Analog Scale (VAS) and SF-36 were measured for functional outcome. Bisegmental kyphosis angle, reduction loss and sagittal alignment parameters were assessed for radiological outcome. Follow up was at least 24 months. Results There was no significant difference regarding our primary functional outcome parameter (ODI) between both groups. Regarding radiological outcome kyphosis angle at time of follow up did not show a significant difference. Reduction loss at time of follow up was moderate in both groups with a significantly lower rate in the percutaneously stabilized group. Surgery time was significantly shorter for posterior stabilization and anterior fusion in the percutaneous group. Time of hospital stay was equal for posterior stabilization but shorter for anterior fusion in the open stabilized group. Conclusion Both treatment strategies are safe and effective showing only minor loss of reduction. Clinical relevant differences in functional and radiographic outcome between the two surgical groups could not be demonstrated. Trial registration It was conducted according to ICMJE guidelines and has been retrospectively registered with the German Clinical Trials Registry (identification number: DRKS00015693, 07.11.2018). |
| first_indexed | 2024-12-21T14:29:48Z |
| format | Article |
| id | doaj.art-2e1542980a4049b997dc19f96d883484 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-21T14:29:48Z |
| publishDate | 2020-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-2e1542980a4049b997dc19f96d8834842022-12-21T19:00:31ZengBMCBMC Musculoskeletal Disorders1471-24742020-02-0121111010.1186/s12891-020-3099-6Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fracturesChristoph J. Erichsen0Christoph-Eckhard Heyde1Christoph Josten2Oliver Gonschorek3Stephanie Panzer4Christian von Rüden5Ulrich J. Spiegl6Department of Trauma Surgery, BG Trauma Center MurnauDepartment of Orthopaedics, Trauma Surgery and Reconstructive Surgery, University of LeipzigDepartment of Orthopaedics, Trauma Surgery and Reconstructive Surgery, University of LeipzigDepartment of Trauma Surgery, BG Trauma Center MurnauDepartment of Radiology, BG Trauma Center MurnauDepartment of Trauma Surgery, BG Trauma Center MurnauDepartment of Orthopaedics, Trauma Surgery and Reconstructive Surgery, University of LeipzigAbstract Background The purpose of this retrospective cohort study was to compare treatment strategies of two level-one trauma centers regarding clinical and radiological outcomes focusing on non-osteoporotic AOSpine type A3 fractures of the thoracolumbar spine at levels T11 to L2. Methods Eighty-seven patients between 18 and 65 years of age that were treated operatively in either of two trauma centers were included. One treatment strategy includes open posterior stabilization whereas the other uses percutaneous posterior stabilization. Both included additional anterior fusion if necessary. Demographic data, McCormack classification, duration of surgery, hospital stay and further parameters were assessed. Owestry Disability Index (ODI), Visual Analog Scale (VAS) and SF-36 were measured for functional outcome. Bisegmental kyphosis angle, reduction loss and sagittal alignment parameters were assessed for radiological outcome. Follow up was at least 24 months. Results There was no significant difference regarding our primary functional outcome parameter (ODI) between both groups. Regarding radiological outcome kyphosis angle at time of follow up did not show a significant difference. Reduction loss at time of follow up was moderate in both groups with a significantly lower rate in the percutaneously stabilized group. Surgery time was significantly shorter for posterior stabilization and anterior fusion in the percutaneous group. Time of hospital stay was equal for posterior stabilization but shorter for anterior fusion in the open stabilized group. Conclusion Both treatment strategies are safe and effective showing only minor loss of reduction. Clinical relevant differences in functional and radiographic outcome between the two surgical groups could not be demonstrated. Trial registration It was conducted according to ICMJE guidelines and has been retrospectively registered with the German Clinical Trials Registry (identification number: DRKS00015693, 07.11.2018).https://doi.org/10.1186/s12891-020-3099-6Thoracolumbar fracturePosterior open instrumentationAdditional anterior fusionPercutaneous fixationSagittal balance |
| spellingShingle | Christoph J. Erichsen Christoph-Eckhard Heyde Christoph Josten Oliver Gonschorek Stephanie Panzer Christian von Rüden Ulrich J. Spiegl Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures BMC Musculoskeletal Disorders Thoracolumbar fracture Posterior open instrumentation Additional anterior fusion Percutaneous fixation Sagittal balance |
| title | Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures |
| title_full | Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures |
| title_fullStr | Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures |
| title_full_unstemmed | Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures |
| title_short | Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures |
| title_sort | percutaneous versus open posterior stabilization in aospine type a3 thoracolumbar fractures |
| topic | Thoracolumbar fracture Posterior open instrumentation Additional anterior fusion Percutaneous fixation Sagittal balance |
| url | https://doi.org/10.1186/s12891-020-3099-6 |
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