[Current treatment options of osteoporotic thoracolumbal spinal fractures]

Retrospective assessment of a patient group, including patients with osteoporotic thoracolumbal fractures. Only patients over 65 years of age were included in the study.

During IX/2005 VII/2006, 45 patients with osteoporotic fractures were managed: 28 females, 17 males aged 65-85 y.o.a, their mean age was 72.6 y.o.a. The mechanisms of the injury included falls in 39 subjects, car- motocycle accidents in 5 subjects, a submerge accident in a single subject. Three patients sufferred from neurological symptoms. TI-TI0 injury was diagnosed in 8 subjects, T11-L2 in 43 subjects, L3-L5 in 5 subjects. Type A injuries prevailed--in 47 subjects, type B injury were diagnosed in 4 subjects, type C in 2 subjects. Conservative therapy was indicated in 25 subjects; transpedicular stabilization in 15 subjects, stabilization using isolated anterior approach in one patient, vertebroplasty in 5 patients. The majority of the injuries were monotraumas--31 subjects, associated traumas in 12 subjects, polytraumas in 2 subjects.

The authors assessed data collected from 25 patients. 6 patients exited, 14 failed to turn up for their follow up examination at 12 months. GDW (Grunddeckplattenwinkel), VAS (Visual Analog Scale) and Oswestry score and complication rates were assessed. Prior to the therapy, the mean VAS score in the conservative group, surgical management and vertebroplasty groups was 7.0: 8.2 and 7.9, respectively; at 12 months the score was reduced to 3.8; 3.4 and 3.7, respectively. The Oswestry score figures in the respective treatment groups were 25.3%, 27.1% and 23.5%. There were no statistically significant differencies between the results. At the time of the injury, the mean GDW in the conservative group was -2 degrees, at 12 months -6 degrees. Prior to vertebroplasty it was +4 degrees, following the procedure +6 degrees, and at 12 months +2 degrees. Prior to surgical stabilization it was -10 degrees, postoperatively +3 degrees and at 12 months 0 degrees. An early infectious complication, a wound absces, was recorded in one patient. A late complication, implant failure, was recorded in the same patient at 6 months postoperatively.

Treatment of osteoporotic thoracolumbal spinal fractures requires individual thorough assessment of therapeutical options.