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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Occurrence of adjacent segment fractures after surgical treatment of an osteoporotic vertebral fracture – a comparison between two different treatment methods

Auftreten von Anschlussfrakturen nach chirurgischer Versorgung einer osteoporotischen Wirbelkörperfraktur – ein Vergleich zwischen zwei verschiedenen Therapiemethoden

Meeting Abstract

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  • presenting/speaker Nazeer Aboud - Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland
  • Christian Senft - Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland
  • Falko Schwarz - Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV046

doi: 10.3205/21dgnc049, urn:nbn:de:0183-21dgnc0493

Published: June 4, 2021

© 2021 Aboud et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Osteoporotic vertebral fractures are a major healthcare problem. A vertebral cement augmentation (VCA) could be used as a minimally invasive surgical approach to manage symptomatic fractures. However, there is a potential risk for an adjacent segment fracture (ASF), which may require second surgery. The addition of transcutaneous screw-fixation with cement-augmentation superior and inferior to the fracture (Hybrid transcutaneous screw-fixation HTSF) may be a good, minimally invasive alternative to reduce the incidence of ASF.

Methods: We have investigated the duration of surgery, hospital stay, intraoperative complication rate and ASF with the need for a surgical therapy in a cohort of 100 consecutive patients receiving either VCA or HTSF in our academic neurosurgical department during the period 2013 to 2018. The median follow-up was 1 year.

Results: During study period, 50 patients received VCA and 50 HTSF. Altogether 68 women (35 VCA; 33 HTSF) and 33 men (15 VCA; 17 HTSF) have been treated. The median-age was 76.5 years (76y VCA; 77 y HTSF). The median duration of surgery was 33.5 min in VCA-group and 99.9 min in the HTSF-group (p < 0.0001). No surgery related complications occurred in the VCA-group with just 1 in the HTSF-group (p = 1). The median hospital stay was 9.5 days in the VCA-group and 11 days in the HTSF-group (p = 0.02). Thirteen patients (26%) in the VCA-group, whereas just four patients (8%) in the HTSF-group developed an adjacent segment fracture in the follow-up (p = 0.031). Ten patients from the VCA-group (10%) und 3 patients (6%) in the HTSF-group received further surgery after the first operation owing to ASF (p = 1).

Conclusion: Based on this single-center cohort, HTSF appears to be a safe and effective option for the treatment of osteoporotic vertebral compression fractures. The duration of surgery was longer than in the HTSF-group, but the rate of ASF can be significantly reduced with the HTSF approach. Further prospective studies are required to address whether HTSF results in a lower revision rate or better postoperative quality of life.

Figure 1 [Fig. 1]