Survival and mortality rate after Minimal-Invasive Hybrid Stabilization (MIHS) in osteoporotic patients with unstable spinal fractures

Introduction:
Minimal invasive hybrid stabilization (MIHS) is a promising treatment for unstable osteoporotic thoracic and lumbar spine fractures, offering benefits such as reduced postoperative pain, fewer complications, early mobilization, and faster discharge. However, long-term outcomes, especially regarding non-trauma-related mortality, are unclear. This study aimed to assess postoperative survival and identify mortality predictors in osteoporotic patients undergoing MIHS.

Methods:
Adult patients treated for unstable thoracic and lumbar fractures at a Level I spine center using MIHS were included. Trauma characteristics, demographics, and 2-year outcomes were analyzed. Patients were divided into survivors (SURV) and non-survivors (MORT) to identify mortality-related factors.

Results:
Seventy-five patients (mean age 82, 72% female) were studied. Forty-nine had OF 3 fractures, and 26 had OF 4 fractures. Average hospital stay was 13 days, with no in-hospital mortality. By 2-year follow-up, 19 patients had died, giving a 75% survival rate. The MORT group showed fewer OF 4 fractures (10.5% vs. 75%, p<0.01) and longer surgery times (p=0.04). Hospital complications were more frequent in the MORT group than in the SURV group (37% vs. 12.5%, p=0.04).

Conclusions:
MIHS is a safe option for treating unstable osteoporotic spine fractures, but the 75% 2-year survival rate suggests significant mortality risks. Factors like fracture type (OF 3 vs. OF 4), longer surgery time, and postoperative complications correlate with higher mortality. Multicenter studies are needed to refine guidelines and improve outcomes for this patient group.

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