Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Fractures With Anterior or Posterior Tension Band Failure (OF 5): Short-Term Results From the Prospective EOFTT Multicenter Study

Georg Osterhoff; Philipp Schenk; Sebastian Katscher; Klaus John Schnake; Martin Bäumlein; Volker Zimmermann; Gregor Schmeiser; Michael A Scherer; Michael Müller; Kai Sprengel; Katja Liepold; Simon Schramm; Christopher Baron; Holger Siekmann; Falko Schwarz; Alexander Franck; Max J Scheyerer; Ulrich J A Spiegl; Bernhard W Ullrich; Working Group Osteoporotic Fractures of the Spine Section of the German Society of Orthopaedics and Trauma

doi:10.1177/21925682221127956

Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Fractures With Anterior or Posterior Tension Band Failure (OF 5): Short-Term Results From the Prospective EOFTT Multicenter Study

Global Spine J. 2023 Apr;13(1_suppl):44S-51S. doi: 10.1177/21925682221127956.

Authors

Georg Osterhoff¹, Philipp Schenk², Sebastian Katscher³, Klaus John Schnake^{4

5}, Martin Bäumlein⁶, Volker Zimmermann⁷, Gregor Schmeiser⁸, Michael A Scherer⁹, Michael Müller¹⁰, Kai Sprengel¹¹, Katja Liepold¹², Simon Schramm¹³, Christopher Baron¹⁴, Holger Siekmann¹⁵, Falko Schwarz¹⁶, Alexander Franck¹⁷, Max J Scheyerer¹⁸, Ulrich J A Spiegl¹, Bernhard W Ullrich^{19

20}; Working Group Osteoporotic Fractures of the Spine Section of the German Society of Orthopaedics and Trauma

Affiliations

¹ Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.
² Department of Science, Research and Education, BG Klinikum Bergmannstrost Halle, Germany.
³ Interdisciplinary Center for Spine and Neurotrauma, Sana Klinikum Borna, Borna, Germany.
⁴ Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Erlangen, Germany.
⁵ Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany.
⁶ Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Marburg, Germany.
⁷ Department of Trauma and Orthopedic Surgery, Klinikum Traunstein, Traunstein, Germany.
⁸ Department of Spine Surgery, Schoen-Klinik Hamburg-Eilbek, Hamburg, Germany.
⁹ Lehrkörper Medizinische Fakultät der Technischen Universität München (Med. Fak. TUM), Arabella-Klinik, Munich, Germany.
¹⁰ Department of Orthopedic and Trauma Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
¹¹ Department of Trauma, University Hospital Zurich, Zurich, Switzerland.
¹² Department of Spine Surgery, Teaching Hospital of the University of Jena, Thuringia Clinic "Georgius Agricola" Saalfeld, Saalfeld, Germany.
¹³ Department of Trauma Surgery, University Hospital Erlangen, Erlangen, Germany.
¹⁴ Spinal Cord Unit, BG Trauma Center, Tubingen, Germany.
¹⁵ Clinic of Trauma-, Hand- and Reconstruction Surgery, AMEOS-Clinic Halberstadt, Halberstadt, Germany.
¹⁶ Department of Neurosurgery, Friedrich Schiller University, Jena University Hospital, Jena, Germany.
¹⁷ Department of Orthopaedics and Trauma Surgery, Regiomed Klinikum Coburg, Germany.
¹⁸ Department of Orthopedics and Trauma Surgery, University Hospital, Moorenstrasse 5, 40225 Düsseldorf, Germany.
¹⁹ Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany.
²⁰ Department of Trauma and Reconstructive Surgery, BG Klinikum Bergmannstrost Halle, Germany.

Abstract

Study design: Subgroup analysis of a multicenter prospective cohort study.

Objective: To analyse surgical strategies applied to osteoporotic thoracolumbar osteoporotic fracture (OF) 5 injuries with anterior or posterior tension band failure and to assess related complications and clinical outcome.

Methods: A multicenter prospective cohort study (EOFTT) was conducted at 17 spine centers including 518 consecutive patients who were treated for an osteoporotic vertebral fracture (OVF). For the present study, only patients with OF 5 fractures were analysed. Outcome parameters were complications, Visual Analogue Scale (VAS), Oswestry Disability Questionnaire (ODI), Timed Up & Go test (TUG), EQ-5D 5L, and Barthel Index.

Results: In total, 19 patients (78 ± 7 years, 13 female) were analysed. Operative treatment consisted of long-segment posterior instrumentation in 9 cases and short-segment posterior instrumentation in 10 cases. Pedicle screws were augmented in 68 %, augmentation of the fractured vertebra was performed in 42%, and additional anterior reconstruction was done in 21 %. Two patients (11 %) received short-segment posterior instrumentation without either anterior reconstruction or cement-augmentation of the fractured vertebra. No surgical or major complications occurred, but general postoperative complications were observed in 45%. At a follow-up of mean 20 ± 10 weeks (range, 12 to 48 weeks), patients showed significant improvements in all functional outcome parameters.

Conclusions: In this analysis of patients with type OF 5 fractures, surgical stabilization was the treatment of choice and lead to significant short-term improvement in terms of functional outcome and quality of life despite a high general complication rate.

Keywords: OF classification; operative; osteoporosis; spine; vertebral fracture.