Einfluss des Operationsverfahrens auf Lebensqualität und Korrekturverlust bei traumatischen Wirbelkörperfrakturen des thorakolumbalen Übergangs

Abstract

Overall outcomes of the four surgical strategies were comparable in our study concerning loss of correction and quality of life, respectively. The use of bone grafts, however, results in a high rate of non-fusion with a remarkable number of patients complaining about bone graft morbidity. Therefore we prefer the use of expandable titanium cages for anterior stabilisation if additional anterior stabilisation is necessary due to type of fracture or damage of adjacent discs. In any other cases, a limited approach by posterior instrumentation alone should be considered.

Combined anteroposterior fixation using a titanium cage versus solely posterior fixation for traumatic thoracolumbar fractures: A systematic review and meta-analysis

“…After the selection based on title and abstract, nine articles seemed eligible for inclusion. After full-text was assessed, two randomized controlled trials (RCTs) and one retrospective cohort study remained eligible for qualitative analysis and could[ 29 30 31 ] be included in the meta-analysis [ Figure 1 ].…”

“…Noticeable differences are fracture levels; one study[ 29 ] only assessed the mid-lumbar region (L2–L4), whereas other studies assessed the thoracolumbar region (T11–L2). [ 30 31 ] The longest mean follow-up was 70 months. [ 30 ] Wang and Liu[ 30 ] also included very severe fractures while Korovessis et al .…”

“…Two studies used a titanium mesh cage filled with autogenous bone,[ 29 30 ] the other study used a titanium expandable cage. [ 31 ] One study used posterior instrumentation with pedicle screws in the fractured vertebra in both groups,[ 29 ] whereas the other two,[ 30 31 ] only used pedicle screws in both groups one level above and below the fractured vertebra. Wang and Liu[ 30 ] additionally performed posterolateral fusion with autogenous bone graft.…”

“…Only Weiner et al . [ 31 ] described the removal of posterior implant in a few patients in both groups before final follow-up.…”

“…All studies reported kyphosis angles and VAS scores although one study reported the VAS-spine score. [ 31 ] Two studies[ 29 30 ] reported complication rates for wound infections and deep venous thrombosis, neurologic improvement on Frankel scale, operation time, bloodloss, and hospital stay. Two studies[ 29 31 ] reported different domains of the SF-36 and were, therefore, not comparable.…”