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Percutaneous versus open posterior stabilization in AOSpine type A3 thoracolumbar fractures.
BMC Musculoskeletal Disorders ( IF 2.3 ) Pub Date : 2020-02-05 , DOI: 10.1186/s12891-020-3099-6
Christoph J Erichsen 1 , Christoph-Eckhard Heyde 2 , Christoph Josten 2 , Oliver Gonschorek 1 , Stephanie Panzer 3, 4 , Christian von Rüden 1, 4 , Ulrich J Spiegl 2
Affiliation  

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).

中文翻译:

AOSpine A3型胸腰椎骨折的经皮与开放后路稳定。

背景技术这项回顾性队列研究的目的是比较两个一级创伤中心在临床和放射学结果方面的治疗策略,重点是T11至L2级胸腰椎的非骨质疏松性AOSpine A3型骨折。方法包括在两个创伤中心中的任何一个接受手术治疗的18到65岁之间的87例患者。一种治疗策略包括开放式后路稳定术,而另一种使用经皮后路稳定术。必要时都包括额外的前路融合术。评估了人口统计学数据,McCormack分类,手术时间,住院时间和其他参数。对功能性结局进行了Owestry残疾指数(ODI),视觉模拟量表(VAS)和SF-36的测量。双节段后凸角 评估减少复位损失和矢状面对准参数的放射学结果。随访至少24个月。结果两组之间的主要功能结局参数(ODI)均无显着差异。关于随访时的放射结局后凸角度没有显示出显着差异。两组在随访时的复位减少程度均中等,经皮稳定组的复位率明显较低。经皮组后路稳定和前路融合的手术时间明显缩短。开放稳定组的后路稳定住院时间相同,但前路融合的住院时间较短。结论两种治疗策略都是安全有效的,仅显示出较小的减少损失。两个手术组之间在功能和放射学结果方面的临床相关差异无法得到证实。试验注册根据ICMJE指南进行,并已向德国临床试验注册中心进行追溯注册(标识号:DRKS00015693,2018年11月7日)。
更新日期:2020-02-06
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