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Osteoporotic vertebral body fractures of the thoracolumbar spine: indications and techniques of a 360°-stabilization

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Unstable vertebral body fragility fractures of the thoracolumbar spine can occur with or without relevant trauma. Initially, a standardized diagnostic algorithm including magnetic resonance tomography is recommended to detect accompanied further vertebral body fractures, to interpret the individual fracture stability, and to screen for relevant traumatic intervertebral disc lesions. Aim of the therapy is to assure fast mobilization and to maintain spinal alignment. Unstable fracture morphology is defined by vertebral body fractures including a relevant defect of the posterior vertebral cortex as well as type B or C fractures. With respect of type A fractures, a combined anterior–posterior approach including a primary cement-augmented posterior stabilization and anterior spondylodesis is indicated in those patients with relevant intervertebral lesions or in those suffering from high-energy accidents resulting in unstable burst-type fractures. The others will benefit from hybrid stabilizations including cement-augmented posterior stabilizations and cement augmentation (kyphoplasty) of the fractured level to gain a ventral transosseous stability. In addition, individually adapted antiosteoporotic therapy is essential.

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Authors and Affiliations

  1. Department for Orthopaedics, Trauma Surgery, and Reconstructive Surgery, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany

    Ulrich Spiegl, J.-S. Jarvers, C.-E. Heyde & C. Josten

Authors
  1. Ulrich Spiegl
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  2. J.-S. Jarvers
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  3. C.-E. Heyde
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  4. C. Josten
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Correspondence to Ulrich Spiegl.

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U. J. Spiegl, J.-S. Jarvers, C.-E. Heyde and C. Josten declare that they have no conflict of interest.

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Spiegl, U., Jarvers, JS., Heyde, CE. et al. Osteoporotic vertebral body fractures of the thoracolumbar spine: indications and techniques of a 360°-stabilization. Eur J Trauma Emerg Surg 43, 27–33 (2017). https://doi.org/10.1007/s00068-016-0751-9

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  • DOI: https://doi.org/10.1007/s00068-016-0751-9

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