Miguel Pishnamaz (Aachen / DE), Aisar Awwad (Aachen / DE), Mohamad Agha Mahmoud (Aachen / DE), Christian Blume (Aachen / DE), Maximilian Praster (Aachen / DE), Christian Herren (Aachen / DE)
Introduction
The diagnosis and treatment of osteoporotic vertebral fractures is challenging and requires a differentiated analysis of influencing factors due to the vulnerable patient population.
Materials
All patients with the OPS code 5-83w.0 for the treatment of osteoporotic spine fractures were identified via the University Hospital's reporting portal between 01/01/2018 and 01/01/2024. A retrospective data analysis was then carried out. All patients who underwent surgical treatment of the spine due to an osteoporotic fracture were included. The fractures were classified based on the OF classification. Demographic parameters and radiological analysis were evaluated.
Results
A total of 113 patients with 123 fractures were identified. Of these, 97 patients with 103 osteoporotic vertebral fractures were included in the study. The mean age at the time of the trauma was 75±11 years, 58% were female. The distribution of osteoporotic vertebral fractures showed 29% thoracic spine injuries and 71% lumbar spine injuries. The distribution of fractures according to OF classification was as follows: 2% OF1 (n=2), 8% OF 2 (n=8), 45% OF 3 (n=46), 31% OF 4 (n=32) and 14% OF 5 (n=15). The bisegmental base/ceiling plate angle improved by 19% from pre- to postoperative (6.71±20.03° vs. 5.48±11.81°). No significant correlation was found between OF Type and pre- or postoperative kyphosis angle (p=0.733; r=-0.35 / p=0.143; r=0.158) or between the other preoperative radiological spinopelvic parameters and the OF classification (pelvic incidence: p=0.900; r=0.013; sacral sclope: p=0.838; r=0.021; pelvic tilt: p=0.434; r=0.084; lumbar lordosis: p=0.587; r=-0.058).
Conclusion
The results of this study indicate that local kyphosis plays a minor role in decision-making regarding the treatment of osteoporotic fractures. However, this observation could be of therapeutic interest in connection with the individual spinopelvic parameters and the resulting different compensation abilities.
MP is consultant for Stryker.
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