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 Journal, 2023 · DOI: 10.1177/21925682221127956 · Published: January 1, 2023

Simple Explanation

This study examines surgical approaches for treating severe osteoporotic spine fractures (OF 5) where the spine's supportive structures have failed, leading to instability. The research analyzes outcomes from 19 patients who underwent either long or short segment spinal fixation, with or without additional procedures like cement augmentation or anterior reconstruction. The study found that surgery improved patients' functional abilities and quality of life, despite a high rate of general complications such as urinary tract infections and pneumonia.

Study Duration

20 ± 10 weeks (range, 12 to 48 weeks)

Participants

19 patients (78 ± 7 years, 13 female) with OF 5 fractures

Evidence Level

Subgroup analysis of a multicenter prospective cohort study

Key Findings

1
Surgical stabilization is an effective treatment for OF 5 fractures, leading to significant short-term improvements in functional outcome and quality of life.
2
Both long-segment and short-segment posterior instrumentation, combined with anterior reconstruction or cement augmentation, are viable surgical options.
3
General postoperative complications, such as urinary tract infections and pneumonia, were common, but no major surgical complications requiring revision occurred during the study period.

Research Summary

This study evaluated surgical strategies for osteoporotic thoracolumbar fractures (OF 5) with anterior or posterior tension band failure, assessing complications and clinical outcomes. The results showed that surgical stabilization led to significant short-term improvements in functional outcome and quality of life, despite a high rate of general complications. Both long and short-segment posterior instrumentation, along with anterior reconstruction or cement augmentation, appear to be viable options for treating these fractures.

Practical Implications

Surgical Treatment Recommendation

Surgical stabilization is a reasonable approach for OF 5 fractures, especially when combined with techniques to enhance stability.

Choice of Instrumentation

Surgeons can consider both long and short-segment posterior instrumentation, tailoring the approach based on individual patient factors and fracture characteristics.

Postoperative Monitoring

Close monitoring for general complications like UTIs and pneumonia is crucial in elderly patients undergoing surgical stabilization for OF 5 fractures.

Study Limitations

1
Short follow-up period (mean 5 months) limits conclusions on long-term outcomes.
2
Small sample size (19 patients) may limit the generalizability of the findings.
3
Lack of data on sagittal or coronal spinal alignment and pre-existing degenerative changes.

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