Relationship Between the OF Classification and Radiological Outcome of Osteoporotic Vertebral Fractures After Kyphoplasty

Abstract

Study Design: Retrospective cohort study. Objectives: The OF classification is a new classification for osteoporotic vertebral fractures. The aim of this study was to clarify the relationship between preoperative OF subgroups and the postoperative outcome after kyphoplasty in patients with such fractures. Methods: Patients who underwent kyphoplasty of a single osteoporotic vertebral fracture were included and divided into groups according to the OF subgroups. Pre- and postoperative plain radiographs were analyzed in regard to the restoration of vertebral body height and local kyphotic angle (LKA). Additionally, clinical data including pre- and postoperative Visual Analogue Scale pain scores was documented. The clinical and radiological results were compared pre- and postoperatively within groups and between groups. Results: A total of 156 patients from OF subgroups 2 to 4 were included (OF 2: n = 58; OF 3: n = 36; OF 4: n = 62). Patients from all groups experienced significant pain relief postoperatively ( P < .001). Patients with OF 2 fractures showed a repositioning of the vertebral body height in the anterior and middle portions (both P < .001), but no significant improvement in LKA. For OF 3 and 4 fractures, there was a significant restoration of vertebral body height ( P < .001 for both) and a significant improvement of LKA ( P < .001 for both). The highest average restoration was noted in the OF 4 group. Conclusions: A higher OF subgroup is related to a higher radiological benefit from kyphoplasty. This confirms that the OF classification is an appropriate tool for the preoperative assessment of osteoporotic fractures.

Treatment and Outcome of Osteoporotic Thoracolumbar Vertebral Body Fractures With Deformation of Both Endplates With or Without Posterior Wall Involvement (OF 4): Short-Term Results from the Prospective EOFTT Multicenter Study

“…The duration between the patients' admission and the treatment decision was 4 ± 4 days (range: 0-26, median 2 days) and did not differ depending on surgical or conservative therapy choice (P = .376). At the day of treatment decision the mean OF-score was 8.2 ± 1.7 (range [4][5][6][7][8][9][10][11][12] and differed between conservative (7.6 ± 1.8) and surgical treated patients (8.4 ± 1.7, P = .029). Thereby a total of 15 patients were treated conservatively despite an OF score of more than 6 and 7 patients were treated surgically despite an OF score of less than 6.…”

“…Taking the recent literature into account stand-alone cement augmentation seems to be justified. Palmowski et al 4,12 reported of favorable clinical and radiological results with reduction potential and low reduction loss in the short run. Similarly, Gu et al 3 reported similar clinical results after both stand-alone kyphoplasty and hybrid stabilization.…”

“…1,2 With regard to treatment, one of the most controversially discussed fracture type are OF 4 injuries with deformation of both endplates and with or without posterior wall involvement. [3][4][5] Generally, the evidence for operative and non-operative treatment of OF 4 type fractures is very limited. 6,7,8 The huge majority of studies did not specifically include OF 4 type fractures.…”

Georg Schmorl prize of the German spine society (DWG) 2022: current treatment for inpatients with osteoporotic thoracolumbar fractures—results of the EOFTT study

“…Posterior stabilization was recommended in unstable fractures, such as OF type 3-5 fractures, depending on the clinical course. To date, several studies have evaluated the treatment of OVCFs using the OF score [2,[9][10][11][12], including the treatment of short-and long-segmental posterior stabilizations. Recently, OF classifications have gained an increased level of acceptance [13][14][15].…”

Relationship between Oral Health Status and Bone Mineral Density in Community-Dwelling Elderly Individuals: A Cross-Sectional Study

“…In addition, fragility fractures lead to physical disability, pain, impaired quality of life, increased mortality, and higher healthcare costs [5]. Therefore, treatment as well as preventive countermeasures for fractures should be instituted, as more elderly individuals are expected to experience fractures in the coming decade [6].…”