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Multicenter evaluation of therapeutic strategies of inpatients with osteoporotic vertebral fractures in Germany

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

Abstract

Purpose

The aim of this study was to assess therapeutic strategies of inpatients with osteoporotic thoracolumbar fractures (OTF) in Germany.

Methods

Prospective multi-center study including 16 German-speaking trauma centers over a period of 7 months. All inpatients with OTF were included. Radiological and clinical data on admission and treatment modalities were assessed.

Results

Seven hundred and seven (99.3%) out of 712 included patients (73.3% female) could be evaluated. Mean age was 75 years (30–103). 51.3% could not remember any traumatic incident. Fracture distribution was from T2 to L5 with L1 (19%) most commonly affected. According to the Magerl classification type A1 (52.1%) and A3 (42.7%) were most common. B and C type injuries (2.6%) and neurological deficits (3.1%) were rare. Previous progression of vertebral deformation was evident in 34.4% of patients and related to t score below − 3 (Odds ratio 1.9661). Patients presented with anticoagulation medication (15.4%), dementia (13%), and ASA score > 3 (12.4%) frequently. 82.3% of patients complained of pain > 4 on VAS, 37% could not be mobilized despite pain medication according to grade II WHO pain ladder. 81.6% received operative treatment. Kyphoplasty (63.8%) and hybrid stabilization including kyphoplasty with (14.4%) or without screw augmentation (7.6%) were the techniques most frequently used. Invasiveness of treatment increased with degree of instability.

Conclusions

OTF are mostly type A compression fractures. Patients suffer from severe pain and immobilization frequently. Progression of deformity is correlated to t score below − 3. Treatment of inpatients is mainly surgical, with kyphoplasty followed by hybrid stabilization as commonly used techniques.

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Acknowledgements

We would like to thank our colleagues Prof. Dr. Gholam Pajenda (Vienna) and Sarah Winkelkotte (Frankfurt) for their invaluable support for this study. Further, we thank the participating clinics for their contribution and efforts to realize this study.

Funding

No funds, grants, or other support were received.

Author information

Authors and Affiliations

  1. Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St. Marien, Rathsberger Strasse 57, 91054, Erlangen, Germany

    Klaus John Schnake

  2. Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany

    Klaus John Schnake

  3. Klinik für Allgemein, Viszeral-und Thoraxchirurgie im Klinikum Hanau, Hanau, Germany

    Nabila Bouzakri

  4. Abteilung für Wirbelsäulenchirurgie und Orthopädische Schmerztherapie, Marienkrankenhaus Schwerte, Schwerte, Germany

    Patrick Hahn

  5. Klinik für Orthopädie und Unfallchirurgie, Klinikum Coburg, Coburg, Germany

    Alexander Franck

  6. Department of Spine Surgery and Traumatology, Schwarzach Orthopaedic Hospital, Schwarzach, Germany

    Thomas R. Blattert

  7. Department of Traumtology and Orthopedic Surgery, Klinikum Traunstein, Traunstein, Germany

    Volker Zimmermann

  8. Abteilung Wirbelsäulenchirurgie, Berufsgenossenschaftliche Unfallklinik, Murnau, Germany

    Oliver Gonschorek

  9. Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University, Jena, Germany

    Bernhard Ullrich

  10. Center for Spinal Surgery and Neurotraumatology, BG-Unfallklinik Frankfurt, Frankfurt, Germany

    Frank Kandziora

  11. Department of Orthopedics and Trauma Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany

    Michael Müller

  12. Center of Spine Surgery and Neurotraumatology, Sana Hospital Borna, Borna, Germany

    Sebastian Katscher

  13. Center for Trauma and Orthopedic Surgery, Gemeinschaftsklinikum Mittelrhein, Ev. Stift, Koblenz, Germany

    Frank Hartmann

  14. Department of Trauma and Orthopedic Surgery, St. Anna Hospital Sulzbach-Rosenberg, Sulzbach-Rosenberg, Germany

    Sven Mörk

  15. Clinic for Trauma, Orthopedic and Spine Surgery, Ortenauklinikum Lahr-Ettenheim, Lahr, Germany

    Akhil Verheyden

  16. Klinik für Unfallchirurgie, Handchirurgie und Orthopädie, Klinikum Memmingen, Memmingen, Germany

    Christian Schinkel

  17. Klinik für Orthopädie und Unfallchirurgie, Klinikum Coburg, Coburg, Germany

    Stefan Piltz

  18. Klinik für Unfall-, Wiederherstellungs- und Orthopädische Chirurgie, Städtisches Klinikum, Dresden, Germany

    Annett Olbrich

  19. Department of Trauma and Reconstructive Surgery, BG Hospital Bergmannstrost, Halle (Saale), Germany

    Bernhard Ullrich

  20. Klinik für Allgemein-, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität, Campus Großhadern, München, Germany

    Stefan Piltz

Authors
  1. Klaus John Schnake
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  2. Nabila Bouzakri
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  3. Patrick Hahn
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  8. Bernhard Ullrich
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  10. Michael Müller
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  11. Sebastian Katscher
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  12. Frank Hartmann
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  13. Sven Mörk
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  14. Akhil Verheyden
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  15. Christian Schinkel
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  16. Stefan Piltz
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  17. Annett Olbrich
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Corresponding author

Correspondence to Klaus John Schnake.

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Schnake, K.J., Bouzakri, N., Hahn, P. et al. Multicenter evaluation of therapeutic strategies of inpatients with osteoporotic vertebral fractures in Germany. Eur J Trauma Emerg Surg 48, 1401–1408 (2022). https://doi.org/10.1007/s00068-021-01708-x

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  • DOI: https://doi.org/10.1007/s00068-021-01708-x

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